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NPI Code Detail

MEDICARE: DR. ERIC L SHIRLEY D.M.D.

MEDICARE: DR. ERIC L SHIRLEY D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDS027881-LPA

General Provider Information

NPI Number : 1700889698
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIC L SHIRLEY D.M.D.
Provider Business Mailing Address
First Line : 4002 LINGLESTOWN RD
Second Line :
City : HARRISBURG
State : PA
Zip : 17112-1017
Country : US
Telephone Number : 717-657-0934
Fax Number : 717-657-3918
Provider Business Practice Location Address
First Line : 4002 LINGLESTOWN RD
Second Line :
City : HARRISBURG
State : PA
Zip : 17112-1017
Country : US
Telephone Number : 717-657-0934
Fax Number : 717-657-3918
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 07/08/2007

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