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Organization
DR. EDWIN KENT SHIRLEY
Active
Organization
DR. EDWIN KENT SHIRLEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN KENT SHIRLEY DDS (DOCTOR OF DENTAL SURGERY)
(701) 235-8402
Entity
Organization
Contact information
Practice address
1231 27TH ST S, STE B, FARGO, ND 58103-8722
(701) 235-8402
Mailing address
1231 27TH ST S, STE B, FARGO, ND 58103-8722
(701) 235-8402
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1596
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132811
—
ND
Enumeration date
05/15/2014
Last updated
05/15/2014
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