| Edward V. Shagam, .d.d.s., P.a. | |
| 
					9 Garden St # 11 Mount Holly NJ 08060-1839  | |
| (609) 267-2266 | |
| (856) 983-1334 | 
| Full Name | Edward V. Shagam, .d.d.s., P.a. | 
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics | 
| Location | 9 Garden St # 11, Mount Holly, New Jersey | 
| Authorized Official Name and Position | Edward V Shagam (PRESIDENT) | 
| Authorized Official Contact | 6092672266 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Edward V. Shagam, .d.d.s., P.a. 9 Garden St # 11 Mount Holly NJ 08060-1839 Ph: (609) 267-2266  | Edward V. Shagam, .d.d.s., P.a. 9 Garden St # 11 Mount Holly NJ 08060-1839 Ph: (609) 267-2266  | 
| NPI Number | 1992724074 | 
|---|---|
| Provider Enumeration Date | 07/19/2006 | 
| Last Update Date | 08/22/2020 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1992724074 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DS 11833 (New Jersey) | Primary | 
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