DR. Jason Edward Shockley, MS, DDS

NPI #1255823688 in Craig, Colorado

Provider Information

NPI Number: 1255823688
Entity Type: Individual
Name: DR. Jason Edward Shockley, MS, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: MS, DDS
Enumeration Date: Jun 1, 2018
Last Updated: Jun 19, 2018

Practice Location

Address: 580 PERSHING ST
City: Craig
State: Colorado
ZIP Code: 81625
Phone: (970) 824-9785

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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