Provider Demographics
NPI:1255439220
Name:SHORR, JAMES H (DDS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:SHORR
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 1:12875 CUMMING HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-4884
Mailing Address - Country:US
Mailing Address - Phone:678-845-0366
Mailing Address - Fax:
Practice Address - Street 1:12875 CUMMING HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-4884
Practice Address - Country:US
Practice Address - Phone:678-845-0366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA117931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice