Organization
BRADFORD C SHINAMAN DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADFORD C SHINAMAN DDS PA (OWNER)
(336) 667-6081
Entity
Organization
Contact information
Practice address
406 8TH ST, NORTH WILKESBORO, NC 28659-4130
(336) 667-6081
Mailing address
PO BOX 606, NORTH WILKESBORO, NC 28659-0606
(336) 667-6081
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8997781
—
NC
Enumeration date
05/12/2008
Last updated
06/11/2008
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