Individual
JEFFREY STUART SHIRLEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
12647 OLIVE BLVD, SUITE 600, SAINT LOUIS, MO 63141-6345
(800) 325-3982
Mailing address
4804 PARK AVE, RICHMOND, VA 23226-1226
(804) 304-7294
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401005913
VA
Other
Enumeration date
04/27/2006
Last updated
07/08/2007
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