Provider Demographics
NPI:1881742351
Name:SHOR, ALEKSANDR I (DMD)
Entity type:Individual
Prefix:DR
First Name:ALEKSANDR
Middle Name:I
Last Name:SHOR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 MONMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1502
Mailing Address - Country:US
Mailing Address - Phone:732-531-8533
Mailing Address - Fax:732-531-0584
Practice Address - Street 1:251 MONMOUTH RD
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1502
Practice Address - Country:US
Practice Address - Phone:732-531-8533
Practice Address - Fax:732-531-0584
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0215141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice