Provider Demographics
NPI:1942497458
Name:PATRICIA A SHIPMAN ,DMD AND DEBRA W LOW, DMD,PA
Entity Type:Organization
Organization Name:PATRICIA A SHIPMAN ,DMD AND DEBRA W LOW, DMD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SHIPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:352-373-4924
Mailing Address - Street 1:4436 NW 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6507
Mailing Address - Country:US
Mailing Address - Phone:352-373-4924
Mailing Address - Fax:
Practice Address - Street 1:4436 NW 23RD AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6507
Practice Address - Country:US
Practice Address - Phone:352-373-4924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00116971223G0001X
FLDN00109411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty