Individual
DR. DAVID J SHOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
215 E WASHINGTON ST, FAIRMOUNT, IN 46928-1747
(765) 948-4107
Mailing address
215 E WASHINGTON ST, FAIRMOUNT, IN 46928-1747
(765) 948-4107
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12011164A
IN
1223G0001X
General Practice Dentistry
683
FL
Other
Enumeration date
07/11/2008
Last updated
12/11/2020
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