Provider Demographics
NPI:1548324999
Name:GOR, SHIPALEE R (DDS)
Entity type:Individual
Prefix:DR
First Name:SHIPALEE
Middle Name:R
Last Name:GOR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 HADDONFIELD BERLIN RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-3503
Mailing Address - Country:US
Mailing Address - Phone:856-782-7448
Mailing Address - Fax:856-782-3317
Practice Address - Street 1:910 HADDONFIELD BERLIN RD
Practice Address - Street 2:SUITE 8
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-3503
Practice Address - Country:US
Practice Address - Phone:856-782-7448
Practice Address - Fax:856-782-3317
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022850001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice