Organization
SHANNON ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER J SHANNON DMD (MEMBER)
(352) 562-2782
Entity
Organization
Contact information
Practice address
39863 HIGHWAY 27 STE 8, DAVENPORT, FL 33837-7802
(863) 353-6867
(863) 353-6869
Mailing address
39863 HIGHWAY 27 STE 8, DAVENPORT, FL 33837-7802
(863) 353-6867
(863) 353-6869
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
20177
FL
Other
Enumeration date
06/24/2015
Last updated
06/24/2015
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