Individual
DR. IGOR SHISHKIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
934 NE 8TH ST, GRANTS PASS, OR 97526-1641
(541) 471-7062
(541) 471-8539
Mailing address
934 NE 8TH ST, GRANTS PASS, OR 97526-1641
(541) 471-7062
(541) 471-8539
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6927
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122676
—
OR
01
—
661711
UNITED CONCORDIA
OR
Enumeration date
08/25/2005
Last updated
07/09/2007
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