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Organization

SHANNON J DAUGHTRY DDS INC

Active
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Organization

SHANNON J DAUGHTRY DDS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LEA DAUGHTRY (BUSINESS MANAGER)
(760) 344-3262
Entity
Organization

Contact information

Practice address
250 MAIN ST, BRAWLEY, CA 92227-2351
(760) 344-3262
(760) 344-1369
Mailing address
250 MAIN ST, BRAWLEY, CA 92227-2351
(760) 344-3262
(760) 344-1369

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
42141
CA

Other

Enumeration date
10/11/2007
Last updated
11/13/2009
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