# JASON E SHOCKLEY MS, DDS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Yampa Valley Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134613565
- **Authorized official:** DR. JASON E SHOCKLEY MS, DDS (DOCTOR)
- **Authorized official phone:** (970) 824-9785

## Contact information

- **Practice address:** 580 PERSHING ST, CRAIG, CO 81625-3047
- **Practice address phone:** (970) 824-9785
- **Practice address fax:** (970) 824-2215
- **Mailing address:** 580 PERSHING ST, CRAIG, CO 81625-3047
- **Mailing address phone:** (970) 761-3365
- **Mailing address fax:** (970) 824-2215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DEN.00203594 | CO | Yes |

## Other

- **Enumeration date:** 06/19/2018
- **Last updated:** 06/19/2018