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Individual

DR. COREY JOE SHEPPARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
29 BEE ST, 4TH FLOOR, CHARLESTON, SC 29425-0001
(843) 876-8815
Mailing address
469 CESSNA AVE, CHARLESTON, SC 29407-2253
(757) 289-1218

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901019364
MI

Other

Enumeration date
09/28/2006
Last updated
05/09/2012
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