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General NPI Number Information
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NPI Number | 1902321458
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Entity Type | Individual
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Provider Name | PRESTON DURHAM SHURLEY DDS
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Gender | Male
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Dates
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Enumeration Date | 08/06/2017
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 1858 INDEPENDENCE SQ STE A
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City | DUNWOODY
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State | GA
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Zip | 30338-5169
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Country | US
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Telephone | 770-458-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 1858 INDEPENDENCE SQ STE A
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City | DUNWOODY
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State | GA
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Zip | 30338-5169
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Country | US
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Telephone | 770-458-3600
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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 | 16501
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN-122237
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License Number State | GA
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