Individual
DR. JAY SHUKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1340 MATTHEWS TOWNSHIP PKWY, SUITE 101, MATTHEWS, NC 28105-5580
(609) 203-2302
Mailing address
1340 MATTHEWS TOWNSHIP PKWY, SUITE 101, MATTHEWS, NC 28105-5580
(609) 203-2302
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DI2438100
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/17/2009
Last updated
10/14/2015
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