Individual
PRAVIN SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
175 COUNTRY CLUB DR BLDG 300B, STOCKBRIDGE, GA 30281-7388
(678) 565-9452
Mailing address
175 COUNTRY CLUB DR BLDG 300B, STOCKBRIDGE, GA 30281-7388
(678) 565-9452
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN123990
GA
Other
Enumeration date
01/28/2025
Last updated
10/15/2025
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