RICHARD A. SHOCKLEY

PORTAGE, MI
NPI1194775502
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: MI  2901011400)
Enumeration Date2006-05-10
Last Update Date2012-03-23
Business Address
-- RICHARD A. SHOCKLEY D.D.S.
706 W CENTRE AVE
PORTAGE, MI 49024-5310
Phone number: 269-323-1679
Mailing Address
-- RICHARD A. SHOCKLEY D.D.S.
706 W CENTRE AVE
PORTAGE, MI 49024-5310
Phone number: 269-323-1679
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