Organization
JACK C SHADER DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK C SHADER DDS (PRESIDENT)
(248) 625-9444
Entity
Organization
Contact information
Practice address
6300 SASHABAW RD, STE A, CLARKSTON, MI 48436
(248) 625-9444
(248) 625-4813
Mailing address
6300 SASHABAW RD, STE A, CLARKSTON, MI 48436
(248) 625-9444
(248) 625-4813
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11126
MI
Other
Enumeration date
09/06/2006
Last updated
08/22/2020
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