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General NPI Number Information
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NPI Number | 1205293883
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Entity Type | Organization
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Legal Business Name | WILLIAM SHATTUCK, DDS, PLLC
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Dates
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Enumeration Date | 01/27/2016
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Last Update Date | 01/27/2016
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Provider Practice Location Address
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Address Line | 295 FM 156 STE 200
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City | HASLET
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State | TX
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Zip | 76052
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Country | US
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Telephone | 214-934-9287
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Fax | 866-892-0774
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Provider Business Mailing Address
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Address Line | 295 FM 156 STE 200
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City | HASLET
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State | TX
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Zip | 76052
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Country | US
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Telephone | 214-934-9287
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Fax | 866-892-0774
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Authorized Official
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Title or Position | OWNER
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Name | MR. WILLIAM DEAN SHATTUCK
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Credential | DDS
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Telephone | 214-934-9287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 31589
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License Number State | TX
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