| NPI | 1235581125 |
|---|---|
| Former Name | SHANICE DYER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00204257) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN22021) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2020-06-03 |