Jack C Shader DDS PC
General Practice Dentistry · Clarkston, MI
Practice location
6300 Sashabaw RdSte a
Clarkston, MI 48436
- Phone
- (248) 625-9444
- Fax
- (248) 625-4813
NPI record
- NPI
- 1912000977
- Entity type
- Organization (Type 2)
- Enumeration date
- September 6, 2006
- Last updated
- August 22, 2020
- Organization subpart
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Dentistry Primary | 1223G0001X |
11126 | MI |
Authorized official
- Name
- Dr. Jack C Shader, DDS
- Title
- President
- Phone
- (248) 625-9444
About Jack C Shader DDS PC
Jack C Shader DDS PC is a healthcare organization registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 6300 Sashabaw Rd, Ste a, Clarkston, MI 48436. The NPI number 1912000977 was assigned on September 6, 2006 and the record was last updated on August 22, 2020.
Jack C Shader DDS PC lists a license in the registry: #11126 (MI) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.
The authorized official for this organization is Dr. Jack C Shader, DDS, President.
Frequently asked questions
What is the NPI number of Jack C Shader DDS PC?
The NPI number is 1912000977.
What is the phone number of Jack C Shader DDS PC?
The phone number listed for the practice location is (248) 625-9444.
Where is Jack C Shader DDS PC located?
6300 Sashabaw Rd, Ste a, Clarkston, MI 48436.
What is the taxonomy code for Jack C Shader DDS PC?
The primary taxonomy code is 1223G0001X – General Practice Dentistry.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
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