Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. LEO RUSSELL SHOCKLEY JR., D.D.S
ActiveDR. LEO RUSSELL SHOCKLEY JR., D.D.S is a General Dentistry healthcare provider located in FLOODWOOD, Minnesota. NPI 1942290226 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · FLOODWOOD, MN
Registration Details
- NPI Number
- 1942290226
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 26, 2005 (20.814122263784 yrs)
- Last Updated
- May 9, 2017
- License
-
9231 (MN)
Practice Information
- Address
-
601 HIGHWAY 73FLOODWOOD, MN, 557368450Browse MN providers · Browse ZIP 55736
- Phone
- 2184762969
- Fax
- 2184761599
- Primary Specialty
-
General Dentistry
1223G0001X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.