Individual
DR. RICHARD J SHAMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
6287 S REDWOOD RD STE 103, TAYLORSVILLE, UT 84123
(801) 261-2444
Mailing address
4739 S WANDER LN, HOLLADAY, UT 84117-5459
(801) 808-1692
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8583943-9924
UT
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
1381
WY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/02/2008
Last updated
09/06/2018
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