Organization
JEREMIAH SHAKESPEAR DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMIAH D SHAKESPEAR DDS (PRESIDENT)
(503) 325-3533
Entity
Organization
Contact information
Practice address
1775 EXCHANGE ST, ASTORIA, OR 97103-3508
(503) 325-3533
Mailing address
1775 EXCHANGE ST, ASTORIA, OR 97103-3508
(503) 325-3533
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9903
OR
Other
Enumeration date
07/18/2013
Last updated
07/18/2013
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