Lee Stephen Shackelford, DDS

NPI #1780955542 in Vinita, Oklahoma

Provider Information

NPI Number: 1780955542
Entity Type: Individual
Name: Lee Stephen Shackelford, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jan 25, 2012
Last Updated: Mar 19, 2015

Practice Location

Address: 27515 S. 4410 RD.
City: Vinita
State: Oklahoma
ZIP Code: 74301
Phone: (918) 256-4800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary
Dentist - General Practice — General Practice	1223G0001X

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