Provider Demographics
NPI:1174686729
Name:SHAH, BHARAT A (DDS)
Entity type:Individual
Prefix:MR
First Name:BHARAT
Middle Name:A
Last Name:SHAH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MIDDLETOWN BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047
Mailing Address - Country:US
Mailing Address - Phone:215-757-0337
Mailing Address - Fax:215-757-4559
Practice Address - Street 1:300 MIDDLETOWN BLVD
Practice Address - Street 2:STE 101
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-757-0337
Practice Address - Fax:215-757-4559
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019786L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist