Individual
SHALIENA K. GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2050 A SECOND ST SE, KIRTLAND AIRFORCE BASE, ALBUQUERQUE, NM 87117-0001
(505) 846-3064
Mailing address
236 EL CERRO LOOP, LOS LUNAS, NM 87031-9505
(505) 410-5305
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH 2816
NM
Other
Enumeration date
02/12/2010
Last updated
02/12/2010
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