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1205387644
SHANELL DENT
PONCA CITY, OK
NPI
1205387644
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2016-10-20
Last Update Date
2016-10-20
Business Address
-- SHANELL DENT
620 W GRAND AVE
PONCA CITY, OK 74601-5123
Phone number: 580-762-1462
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Mailing Address
-- SHANELL DENT
1928 N 6TH ST
PONCA CITY, OK 74601-2031
Phone number: 580-716-8487
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