Individual
DR. PAUL RICHARD SHAMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
9674 SOUTH RUN OAKS DR., FAIRFAX STATION, VA 22039-2629
(703) 643-3041
Mailing address
9674 SOUTH RUN OAKS DR., FAIRFAX STATION, VA 22039-2629
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
6663
MD
1223P0300X
Periodontics
Primary
DN12279
MA
Other
Enumeration date
07/16/2010
Last updated
07/16/2010
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