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DR. J THAD SHIREY DDS

>> Dentist >> Dental Providers

Registrant NPI Number: 1801907142

Individual Registrant:
DR. J THAD SHIREY DDS
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1090 HWY 10 EAST  BOONEVILLE, AR 72927 US
Tel: 479-675-2009  Fax: 479-675-5446

Contact information for business:
PO BOX 477  BOONEVILLE, AR 72927 US
Tel: 479-675-2009  Fax: 479-675-5446

Registration Information:
NPI: 1801907142
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
AR2222

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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