# DR. EDWIN KENT SHIRLEY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447661186
- **Authorized official:** DR. EDWIN KENT SHIRLEY DDS (DOCTOR OF DENTAL SURGERY)
- **Authorized official phone:** (701) 235-8402

## Contact information

- **Practice address:** 1231 27TH ST S, STE B, FARGO, ND 58103-8722
- **Practice address phone:** (701) 235-8402
- **Mailing address:** 1231 27TH ST S, STE B, FARGO, ND 58103-8722
- **Mailing address phone:** (701) 235-8402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 1596 | ND | Yes |

## Other

- **Enumeration date:** 05/15/2014
- **Last updated:** 05/15/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 132811 | — | ND |