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General NPI Number Information
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NPI Number | 1598122905
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Entity Type | Organization
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Legal Business Name | RINGWOOD FAMILY DENTAL LLC
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Dates
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Enumeration Date | 01/15/2016
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Last Update Date | 01/15/2016
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Provider Practice Location Address
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Address Line | 55 SKYLINE DR SUITE 210
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City | RINGWOOD
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State | NJ
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Zip | 07456-2037
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Country | US
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Telephone | 973-962-4222
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Fax |
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Provider Business Mailing Address
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Address Line | 55 SKYLINE DR SUITE 210
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City | RINGWOOD
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State | NJ
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Zip | 07456-2037
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Country | US
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Telephone | 973-962-4222
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. HARSH SHAH
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Credential | DMD
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Telephone | 973-962-4222
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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 | 22DI02468400
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License Number State | NJ
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