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General NPI Number Information
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NPI Number | 1356457352
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Entity Type | Organization
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Legal Business Name | STEPHEN E. SHPEEN, DMD, LLC
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 546 LIPPINCOTT DR SUITE A
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City | MARLTON
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State | NJ
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Zip | 08053-4807
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Country | US
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Telephone | 856-988-0023
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Fax | 856-088-1203
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Provider Business Mailing Address
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Address Line | 546 LIPPINCOTT DR SUITE A
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City | MARLTON
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State | NJ
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Zip | 08053-4807
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Country | US
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Telephone | 856-988-0023
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Fax | 856-088-1203
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHEN SHPEEN
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Credential | DMD
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Telephone | 856-988-0023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 22DI01400100
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License Number State | NJ
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