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Individual

DR. PHILLIP SHOCKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
7164 HACKS CROSS RD, OLIVE BRANCH, MS 38654-4472
(662) 627-3633
Mailing address
7164 HACKS CROSS RD, OLIVE BRANCH, MS 38654-4472

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4385-23
MS

Other

Enumeration date
06/12/2023
Last updated
06/12/2023
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