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Individual

ALBERT DON SHACKELFORD JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
600 OGLETHORPE AVE, SUITE 2, ATHENS, GA 30606-2263
(706) 353-2298
(706) 353-2298
Mailing address
600 OGLETHORPE AVE, SUITE 2, ATHENS, GA 30606-2263
(706) 353-2298
(706) 353-2298

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
011019
GA

Other

Enumeration date
12/21/2006
Last updated
07/08/2007
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