# SHENAN BRADSHAW DDS MD PA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SHENAN BRADSHAW DDS MD PA
- **Other names:** Mooresville Oral Surgery
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1023813888
- **Legal business name:** SHENAN BRADSHAW DDS MD PA
- **Authorized official:** JENNIFER GRAVES (PRACTICE ADMIN)
- **Authorized official phone:** (704) 799-3555

## Contact information

- **Practice address:** 858 BRAWLEY SCHOOL RD STE C, MOORESVILLE, NC 28117-8208
- **Practice address phone:** (704) 799-3555
- **Mailing address:** 858 BRAWLEY SCHOOL RD STE C, MOORESVILLE, NC 28117-8208

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 02/17/2025
- **Last updated:** 02/17/2025