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Richard A. Shockley, DDS
General Practice Dentistry in Portage, Michigan
NPI 1194775502

Richard A. Shockley is a General Practice Dentistry based in Portage, MI and is specialized in General Practice. Richard A. Shockley practices in Portage, MI and has the professional credentials of DDS. The NPI Number for Richard A. Shockley is 1194775502 and holds a License No. 2901011400 (Michigan).

The current practice location address for Richard A. Shockley is 706 W Centre Ave, Portage, MI and can be reached out via phone at 269-323-1679 and via fax at 269-323-1536.

Location: 706 W Centre Ave, Portage, MI, 49024-5310
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194775502
Provider Name
Richard A. Shockley
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
706 W Centre Ave, Portage, MI, 49024-5310
Phone Number
269-323-1679
Fax Number
269-323-1536
Provider Enumeration Date
05/10/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2908240 05 MI
institution
Provider Business Practice Location Address Details
Address
706 W Centre Ave
City
Portage
State
Michigan
Zip
49024-5310
Phone Number
269-323-1679
Fax Number
269-323-1536
person
Provider Business Mailing Address Details
Address
706 W Centre Ave
City
Portage
State
Michigan
Zip
49024-5310
Phone Number
269-323-1679
Fax Number
269-323-1536
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
2901011400 (Michigan)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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