Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DN00000232 | WA |
NPI | 1982914396 |
---|---|
Provider Name | Robert Keith Sheeler |
First Address | Sequim, WA 98382-3264 |
Second Address | Sequim, WA 98382-3264 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2010 |
Last Update Date | 19/10/2010 |