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General NPI Number Information
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NPI Number | 1851963359
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Entity Type | Individual
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Provider Name | SHAWN MULLEN DMD
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Gender | Male
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Dates
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Enumeration Date | 07/14/2021
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Last Update Date | 07/14/2021
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Provider Practice Location Address
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Address Line | 3612 AUSTIN DAVIS AVE
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City | TALLAHASSEE
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State | FL
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Zip | 32308-7401
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Country | US
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Telephone | 850-877-0215
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Fax | 850-329-2642
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Provider Business Mailing Address
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Address Line | 211 SINCLAIR RD
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City | TALLAHASSEE
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State | FL
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Zip | 32312-2713
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Country | US
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Telephone | 813-760-8866
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 26250
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License Number State | FL
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