| Tustin Smiles Dental Office Of Dr. Shah | |
|
17601 17th St Ste 100 Tustin CA 92780-1946 | |
| (714) 544-7511 | |
| (714) 544-8918 |
| Full Name | Tustin Smiles Dental Office Of Dr. Shah |
|---|---|
| Speciality | Dentist |
| Location | 17601 17th St Ste 100, Tustin, California |
| Authorized Official Name and Position | Amit Lalit Shah (OWNER) |
| Authorized Official Contact | 5626943984 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tustin Smiles Dental Office Of Dr. Shah 17601 17th St Ste 100 Tustin CA 92780-1946 Ph: (714) 544-7511 | Tustin Smiles Dental Office Of Dr. Shah 17601 17th St Ste 100 Tustin CA 92780-1946 Ph: (714) 544-7511 |
| NPI Number | 1225166127 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 02/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225166127 | NPI | - | NPPES |
| G9331401 | Other | CA | MEDICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 49805 (California) | Primary |
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