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General NPI Number Information
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NPI Number | 1679860969
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Entity Type | Organization
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Legal Business Name | WILLIAM T. SHIPLEY, D.D.S., M.S.D.
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Dates
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Enumeration Date | 07/07/2011
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Last Update Date | 07/07/2011
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Provider Practice Location Address
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Address Line | 303 N OAK AVE
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City | COOKEVILLE
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State | TN
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Zip | 38501-2439
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Country | US
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Telephone | 931-526-7846
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Fax |
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Provider Business Mailing Address
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Address Line | 303 N OAK AVE
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City | COOKEVILLE
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State | TN
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Zip | 38501-2439
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Country | US
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Telephone | 931-526-7846
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. WILLIAM THURMAN SHIPLEY SR.
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Credential | DDS MSD
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Telephone | 931-626-7846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DS 1549
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License Number State | TN
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