SHANNON KELLY BLAIR

PENASCO, NM
NPI1841823143
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: NM  DD22013)
Additional Taxonomies1223G0001X Dentist, General Practice
(Licence: CA  DDS106783)
Enumeration Date2020-02-15
Last Update Date2024-03-15
Business Address
SHANNON KELLY BLAIR DDS
15136 NM-75
PENASCO, NM 87553
Phone number: 575-587-2205
Mailing Address
SHANNON KELLY BLAIR DDS
PO BOX 158
ESPANOLA, NM 87532-0158
Phone number: 575-587-2205
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