Individual
SHANE BAXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1113 PROGRESS DR, MEDFORD, OR 97504-5201
(541) 535-6239
Mailing address
931 CHEVY WAY, MEDFORD, OR 97504-4127
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D12341
OR
Other
Enumeration date
06/03/2026
Last updated
06/05/2026
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