Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 11615 | NC |
NPI | 1154971042 |
---|---|
Provider Name | Dr. Sweety Dayanand Shah |
First Address | Fort Mill, SC 29715-0014 |
Second Address | Fort Mill, SC 29715-0014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2019 |
Last Update Date | 19/02/2021 |