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General NPI Number Information
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NPI Number | 1790952489
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Entity Type | Organization
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Legal Business Name | BRADFORD C SHINAMAN DDS PA
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 406 8TH ST
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City | NORTH WILKESBORO
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State | NC
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Zip | 28659-4130
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Country | US
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Telephone | 336-667-6081
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 606
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City | NORTH WILKESBORO
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State | NC
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Zip | 28659-0606
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Country | US
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Telephone | 336-667-6081
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRADFORD C SHINAMAN
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Credential | DDS PA
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Telephone | 336-667-6081
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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 |
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License Number State |
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