4th Avenue Dental PC
NPI #1356580914 in Mount Vernon, New York
Provider Information
- NPI Number
- 1356580914
- Entity Type
- Organization
- Organization Name
- 4th Avenue Dental PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Feb 5, 2009
- Last Updated
- Feb 5, 2009
Practice Location
- Address
- 157 S 4TH AVE
- City
- Mount Vernon
- State
- New York
- ZIP Code
- 10550-3106
- Phone
- (914) 664-5342
Authorized Official
- Name
- DR. HARESH I SHAH, DDS
- Title
- PRESIDENT
- Phone
- (914) 664-5342
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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