Individual
AUSTIN JAMES SHACKELFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
675 BALTIMORE DR, WILKES BARRE, PA 18702-7900
(570) 808-5626
(570) 808-6352
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 808-5626
(570) 808-6352
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
DS045082
PA
Other
Enumeration date
03/09/2018
Last updated
08/15/2025
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