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1235355017
MYRA SHIVERS
FAYETTEVILLE, GA
NPI
1235355017
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0300X Dentist Periodontics
(Licence: GA 9975)
Enumeration Date
2007-04-18
Last Update Date
2007-07-08
Business Address
DR. MYRA SHIVERS
118 N PARK DR
FAYETTEVILLE, GA 30214-1645
Phone number: 770-460-6765
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Mailing Address
DR. MYRA SHIVERS
118 N PARK DR
FAYETTEVILLE, GA 30214-1645
Phone number: 770-460-6765
Copy
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