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General NPI Number Information
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NPI Number | 1659373777
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Entity Type | Individual
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Provider Name | NOOR A. SHAMIM DMD
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 02/04/2013
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Provider Practice Location Address
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Address Line | 544 ROUTE 6 AND 209 SUITE 1A
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City | MILFORD
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State | PA
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Zip | 18337-9439
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Country | US
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Telephone | 570-296-2569
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Fax | 570-296-0419
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Provider Business Mailing Address
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Address Line | 544 ROUTE 6 AND 209 SUITE 1A
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City | MILFORD
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State | PA
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Zip | 18337-9439
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Country | US
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Telephone | 570-296-2569
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Fax | 570-296-0419
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DS030500L
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License Number State | PA
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