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Individual

DR. ALAN DAVID SHOOPAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.,P.A.

Contact information

Practice address
6311 4TH ST N, ST PETERSBURG, FL 33702-7511
(727) 522-5599
(727) 526-1702
Mailing address
6311 4TH ST N, ST PETERSBURG, FL 33702-7511
(727) 522-5599

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DN15199
MA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN9319
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
075690300
FL
05
110010278A
MA
Enumeration date
02/01/2007
Last updated
10/06/2017
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