Individual
DR. JONATHAN SHAFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
652 HAMILTON RD., USA DENTAL ACTIVITY, FORT SILL, OK 73503
(580) 442-3905
(580) 442-4002
Mailing address
652 HAMILTON RD., USA DENTAL ACTIVITY, FORT SILL, OK 73503
(580) 442-3905
(580) 442-4002
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
31981
TX
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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