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Individual
DR. MYSTY SHAVER
Active
Individual
DR. MYSTY SHAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9192
IA
1223G0001X
General Practice Dentistry
DDS-09192
IA
Other
Enumeration date
06/12/2015
Last updated
10/14/2024
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