Whalio Doctors

NPI 1215932504

Stephen Mark Shall, DDS

Practitioner Oral & Maxillofacial Surgery (D.M.D.) Sylvania, OH

Practice location

Address
5690 Monroe St, Sylvania, OH 43560-2736
Phone
(419) 479-3939
Fax
(419) 479-3933
Mailing address
5690 Monroe St STE a, Sylvania, OH 43560-2736

Registered specialties (2)

Oral & Maxillofacial Surgery (D.M.D.) Primary
Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence 30.016634 (OH)
Oral and Maxillofacial Surgery (Dentist)
Dental Providers Taxonomy 1223S0112X Licence 16634 (OH)

Registry record

NPI
1215932504
Entity type
Individual
Sex (as registered)
Male
NPI issued
15 Jun 2005
Record last updated
1 Aug 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.