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General NPI Number Information
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NPI Number | 1952315301
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Entity Type | Organization
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Legal Business Name | SHENAN BRADSHAW DDS MD PA
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 2708 HENRY ST
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City | GREENSBORO
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State | NC
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Zip | 27405-3633
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Country | US
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Telephone | 336-621-1554
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Fax | 336-621-3402
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Provider Business Mailing Address
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Address Line | 2708 HENRY ST
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City | GREENSBORO
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State | NC
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Zip | 27405
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Country | US
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Telephone | 336-621-1554
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Fax | 336-621-3402
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | KAREN STRICKLER
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Credential |
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Telephone | 336-621-1554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 5525
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License Number State | NC
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