Individual
ELIZABETH SHOCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
2953 BROAD AVE, MEMPHIS, TN 38112-2957
(901) 701-2720
Mailing address
2595 CENTRAL AVE, MEMPHIS, TN 38104-5905
(910) 228-3708
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9728
NC
122300000X
Dentist
Primary
9836
TN
Other
Enumeration date
06/19/2014
Last updated
06/01/2022
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