Individual
DR. BANSARI SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.D.S., M.D.S.
Contact information
Practice address
2124 OGDEN AVENUE, SUITE 104, AURORA, IL 60504
(630) 585-6100
(630) 778-2070
Mailing address
2124 OGDEN AVENUE, SUITE 104, AURORA, IL 60504
(630) 585-6100
(630) 778-2070
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
021.003210
IL
390200000X
Student in an Organized Health Care Education/Training Program
10355
KY
Other
Enumeration date
02/18/2020
Last updated
12/20/2023
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