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Organization

MICHAEL A. SHANNON, D.D.S., M.S., INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL A. SHANNON D.D.S., M.S. (PRESIDENT)
(949) 573-5654
Entity
Organization

Contact information

Practice address
206 CALLE POTRANCA, SAN CLEMENTE, CA 92672-4552
(949) 573-5654
Mailing address
206 CALLE POTRANCA, SAN CLEMENTE, CA 92672-4552
(949) 573-5654

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
05/02/2007
Last updated
08/22/2020
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