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General NPI Number Information
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NPI Number | 1407973977
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Entity Type | Organization
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Legal Business Name | JOHN E SHEPPARD DDS PA
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 438 GANTTOWN RD SUITE A6
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City | SEWELL
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State | NJ
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Zip | 08080-2341
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Country | US
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Telephone | 856-589-8012
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Fax | 856-589-8013
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Provider Business Mailing Address
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Address Line | PO BOX 8548
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-8548
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Country | US
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Telephone | 856-589-8012
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Fax | 856-589-8013
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN E SHEPPARD
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Credential | DDS
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Telephone | 856-589-8012
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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 | 22DI01177300
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License Number State | NJ
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