Provider Demographics
NPI:1063724029
Name:SHAUL, JAMES ALLAN (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALLAN
Last Name:SHAUL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2D DENBN/NDC, PSC BOX 20130
Mailing Address - Street 2:COMMANDING OFFICER
Mailing Address - City:CAMP LEJEUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28542-0130
Mailing Address - Country:US
Mailing Address - Phone:910-451-2208
Mailing Address - Fax:910-451-8036
Practice Address - Street 1:700 MCHUGH BLVD
Practice Address - Street 2:
Practice Address - City:CAMP LEJEUNE
Practice Address - State:NC
Practice Address - Zip Code:28542-0130
Practice Address - Country:US
Practice Address - Phone:910-450-1658
Practice Address - Fax:910-451-8036
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-07
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC09623122300000X
PADS038308122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist