Individual
BRETT MCCANN SHIRLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
4800 NE STALLINGS DR STE 113, NACOGDOCHES, TX 75965
(936) 305-5155
(936) 305-5322
Mailing address
4800 NE STALLINGS DR STE 113, NACOGDOCHES, TX 75965-1250
(936) 305-5155
(936) 305-5322
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
207796
LA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
23935
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
50203
AZ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Q0829
TX
Other
Enumeration date
03/25/2008
Last updated
12/12/2018
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