Individual
DR. MICHAEL DERAE SHEPPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2310 FM 157 NORTH, SUITE 103, MANSFIELD, TX 76063
(817) 477-0922
(817) 477-0910
Mailing address
2310 FM 157 NORTH, SUITE 103, MANSFIELD, TX 76063
(817) 477-0922
(817) 477-0910
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
21182
TX
Other
Enumeration date
05/22/2006
Last updated
03/25/2009
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