| Shannon Orthodontics Llc | |
|
39863 Highway 27 Ste 8 Davenport FL 33837-7802 | |
| (863) 353-6867 | |
| (863) 353-6869 |
| Full Name | Shannon Orthodontics Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 39863 Highway 27 Ste 8, Davenport, Florida |
| Authorized Official Name and Position | Christopher J Shannon (MEMBER) |
| Authorized Official Contact | 3525622782 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shannon Orthodontics Llc 39863 Highway 27 Ste 8 Davenport FL 33837-7802 Ph: (863) 353-6867 | Shannon Orthodontics Llc 39863 Highway 27 Ste 8 Davenport FL 33837-7802 Ph: (863) 353-6867 |
| NPI Number | 1700268802 |
|---|---|
| Provider Enumeration Date | 06/24/2015 |
| Last Update Date | 06/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700268802 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 20177 (Florida) | Primary |
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