Provider Demographics
NPI:1609947241
Name:SHETH, AMISH (DMD)
Entity Type:Individual
Prefix:DR
First Name:AMISH
Middle Name:
Last Name:SHETH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 MIDDLETOWN BLVD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1818
Mailing Address - Country:US
Mailing Address - Phone:215-757-4400
Mailing Address - Fax:215-757-6405
Practice Address - Street 1:402 MIDDLETOWN BLVD
Practice Address - Street 2:SUITE #200
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1818
Practice Address - Country:US
Practice Address - Phone:215-757-4400
Practice Address - Fax:215-757-6405
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0360631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice