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General NPI Number Information
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NPI Number | 1841661394
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Entity Type | Organization
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Legal Business Name | DENNIS D SHEPARD MD INC
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Dates
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Enumeration Date | 10/09/2015
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Last Update Date | 10/09/2015
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Provider Practice Location Address
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Address Line | 1418 E MAIN ST STE 130
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City | SANTA MARIA
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State | CA
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Zip | 93454-4836
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Country | US
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Telephone | 805-614-7591
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Fax | 805-614-7592
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Provider Business Mailing Address
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Address Line | 1418 E MAIN ST STE 130
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City | SANTA MARIA
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State | CA
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Zip | 93454-4836
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Country | US
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Telephone | 805-614-7591
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Fax | 805-614-7592
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. FRANZISKA SHEPARD
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Credential |
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Telephone | 805-614-7591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A69671
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License Number State | CA
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