| NPI | 1538554407 |
|---|---|
| Former Name | SHAYNA MICHELLE ADAMOVICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 202835) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS040960) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2024-08-27 |