| NPI | 1700047313 |
|---|---|
| Other Name | SHELLEY DIANE IRVING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 6943) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: OR D9100) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2011-06-16 |