Organization
DR. EDWIN KENT SHIRLEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN KENT SHIRLEY DDS (DOCTOR OF DENTAL SURGERY)
(701) 235-8402
Entity
Organization
Contact information
Practice address
1231 27TH ST S, STE B, FARGO, ND 58103-8722
(701) 235-8402
Mailing address
1231 27TH ST S, STE B, FARGO, ND 58103-8722
(701) 235-8402
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1596
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132811
—
ND
Enumeration date
05/15/2014
Last updated
05/15/2014
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