| NPI | 1750496840 |
|---|---|
| Former Name | SHAWNA NICOLE NEERGAARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 9888) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CO 9015) |
| 1223G0001X Dentist General Practice (Licence: TX 23689) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2015-04-07 |