Individual
LEVI J.O. SHULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1211 LIBERTY ST SE, SALEM, OR 97302-4243
(503) 362-5019
Mailing address
6395 KEIZER STATION BLVD, SALEM, OR 97304
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9962
OR
Other
Enumeration date
10/03/2013
Last updated
07/23/2019
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