| NPI | 1982131306 |
|---|---|
| Doing Business As | WILLOW GLEN DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | RAOUL R SHAH Owner 408-266-6144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223E0200X Dentist, Endodontics | |
| 1223P0300X Dentist, Periodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2024-05-09 |