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General NPI Number Information
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NPI Number | 1679370274
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Entity Type | Organization
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Legal Business Name | BANSAL SHAH DENTAL PC
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Dates
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Enumeration Date | 03/01/2025
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Last Update Date | 03/01/2025
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Provider Practice Location Address
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Address Line | 59 WASHINGTON AVE
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City | CHELSEA
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State | MA
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Zip | 02150-3906
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Country | US
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Telephone | 617-889-2668
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Fax |
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Provider Business Mailing Address
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Address Line | 26 WORCESTER ST APT 510
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City | BOSTON
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State | MA
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Zip | 02118-3377
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Country | US
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Telephone | 347-741-1152
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | ANKITA BANSAL
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Credential | DMD
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Telephone | 347-741-1152
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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 |
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License Number State |
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