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Individual
DR. RAYMOND PATRICK SHUPAK
Active
Individual
DR. RAYMOND PATRICK SHUPAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
35670
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS038719
PA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
MD461668
PA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
S4567
TX
Other
Enumeration date
06/22/2011
Last updated
05/24/2021
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