| Shull Family Dentistry | |
|
1211 Liberty St Se Salem OR 97302-4243 | |
| (503) 362-5019 | |
| Not Available |
| Full Name | Shull Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 1211 Liberty St Se, Salem, Oregon |
| Authorized Official Name and Position | Levi James-oliver Shull (OWNER) |
| Authorized Official Contact | 9712698004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shull Family Dentistry 1211 Liberty St Se Salem OR 97302-4243 Ph: () - | Shull Family Dentistry 1211 Liberty St Se Salem OR 97302-4243 Ph: (503) 362-5019 |
| NPI Number | 1407416746 |
|---|---|
| Provider Enumeration Date | 06/18/2019 |
| Last Update Date | 07/23/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407416746 | NPI | - | NPPES |
| 140728500 | Other | OWNER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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