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General NPI Number Information
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NPI Number | 1770834053
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Entity Type | Organization
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Legal Business Name | GEORGE J. SHIA, D.D.S., INC.
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Dates
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Enumeration Date | 09/26/2012
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Last Update Date | 09/26/2012
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Provider Practice Location Address
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Address Line | 5527 SUNSHINE DR
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City | AUSTIN
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State | TX
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Zip | 78756-2223
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Country | US
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Telephone | 512-454-2777
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Fax | 512-454-0140
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Provider Business Mailing Address
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Address Line | 5527 SUNSHINE DR
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City | AUSTIN
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State | TX
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Zip | 78756-2223
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Country | US
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Telephone | 512-454-2777
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Fax | 512-454-0140
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEORGE JOSEPH SHIA
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Credential | D.D.S.
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Telephone | 512-454-2777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 6124
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License Number State | TX
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