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General NPI Number Information
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NPI Number | 1336311406
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Entity Type | Organization
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Legal Business Name | DR. R. SHAH DENTISTRY PC
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Dates
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Enumeration Date | 03/29/2008
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Last Update Date | 03/29/2008
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Provider Practice Location Address
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Address Line | 1004 PRINCETOWN RD
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City | SCHENECTADY
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State | NY
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Zip | 12306-9766
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Country | US
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Telephone | 518-355-5492
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Fax | 518-357-9928
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Provider Business Mailing Address
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Address Line | 1004 PRINCETOWN RD
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City | SCHENECTADY
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State | NY
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Zip | 12306-9766
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Country | US
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Telephone | 518-355-5492
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Fax | 518-357-9928
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAJNIKANT SHAH
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Credential | DDS
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Telephone | 518-355-5492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 033326
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License Number State | NY
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