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General NPI Number Information
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NPI Number | 1326408261
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Entity Type | Organization
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Legal Business Name | ALLURE DENTAL
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | 1353 W MILL ST
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City | SAN BERNARDINO
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State | CA
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Zip | 92410-2244
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Country | US
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Telephone | 909-567-2024
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Fax | 909-453-0889
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Provider Business Mailing Address
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Address Line | 1353 W MILL ST SUITE 114
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City | SAN BERNARDINO
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State | CA
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Zip | 92410-2223
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Country | US
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Telephone | 909-567-2024
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Fax | 909-453-0889
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Authorized Official
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Title or Position | PARTNER
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Name | DR. RAJESH M SHAH
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Credential | DDS
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Telephone | 951-280-9300
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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 | 46135
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License Number State | CA
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