| James M Shaddock Dds Pc | |
|
3705 W 12th Street Greeley CO 80634 | |
| (970) 356-2605 | |
| (970) 304-6804 |
| Full Name | James M Shaddock Dds Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3705 W 12th Street, Greeley, Colorado |
| Authorized Official Name and Position | James M Shaddock (DENTIST) |
| Authorized Official Contact | 9703562605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James M Shaddock Dds Pc 3705 W 12th Street Greeley CO 80634 Ph: (970) 356-2605 | James M Shaddock Dds Pc 3705 W 12th Street Greeley CO 80634 Ph: (970) 356-2605 |
| NPI Number | 1730256033 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730256033 | NPI | - | NPPES |
| 02043016 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 430 (Colorado) | Primary |
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