Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DEN00203879 | CO |
NPI | 1093246837 |
---|---|
Provider Name | Anne Shaffer |
First Address | Danville, PA 17822-9800 |
Second Address | Denver, CO 80221-2721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2017 |
Last Update Date | 14/06/2019 |