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Individual

DR. STEPHEN ROBERT SHEPHERD

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
12569 NEWPORT AVE, TUSTIN, CA 92780-2420
(714) 544-2220
(714) 544-2701
Mailing address
12569 NEWPORT AVE, TUSTIN, CA 92780-2420
(714) 544-2220
(714) 544-2701

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
31706
CA

Other

Enumeration date
12/16/2005
Last updated
07/08/2007
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