Individual
PURNA NANDAN SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
G3538 MILLER RD, SUITE A, FLINT, MI 48507-1271
(810) 620-7536
Mailing address
6238 EASTKNOLL DR, APT 114, GRAND BLANC, MI 48439-5017
(989) 387-9767
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901021200
MI
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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