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General NPI Number Information
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NPI Number | 1104310937
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Entity Type | Individual
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Provider Name | ANGELA SHEN DDS
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Gender | Female
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Dates
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Enumeration Date | 06/15/2018
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Last Update Date | 03/03/2020
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Provider Practice Location Address
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Address Line | 1765 N TOWN EAST BLVD STE 111
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City | MESQUITE
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State | TX
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Zip | 75150-4151
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Country | US
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Telephone | 972-270-7210
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Fax |
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Provider Business Mailing Address
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Address Line | 2660 N HASKELL AVE APT 2129
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City | DALLAS
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State | TX
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Zip | 75204-2951
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Country | US
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Telephone | 214-636-5174
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 34071
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License Number State | TX
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