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Provider Information for 1073719506



DR. DOUGLAS ALAN SHEALY D.D.S.

Gender: MALE

Individual NPI: 1073719506

Calendar Last Updated: 2007-07-08

Details

Name Value
NPI 1073719506
Enumeration Date 2007-06-22
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 20 CHRISTA DR
ROWLEY, MA 01969-1900
United States

Phone: 978-948-7317 | Fax:
View Map External Link
Primary Practice Address 434 HAVERHILL ST
ROWLEY, MA 01969-1914
United States

Phone: 978-948-2333 | Fax:
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice MA 15182
Other Identifiers
Issuer State Number
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location