Provider Demographics
NPI:1114981693
Name:MCGEE, SHANNON STUART (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:STUART
Last Name:MCGEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 EDINBORO DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-7540
Mailing Address - Country:US
Mailing Address - Phone:910-528-0444
Mailing Address - Fax:
Practice Address - Street 1:2891 ROUTE 22
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:NY
Practice Address - Zip Code:12563-2228
Practice Address - Country:US
Practice Address - Phone:845-306-0910
Practice Address - Fax:845-306-0911
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH185961223G0001X
NC85241223G0001X
NY059638-011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice