Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | 0516846206 | OR |
NPI | 1437351285 |
---|---|
Provider Name | Ms. Shawn M Murray |
First Address | Florence, OR 97439 |
Second Address | Florence, OR 97439 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 08/07/2007 |