Individual
DR. TRAVIS TRENT SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
901 CENTER STREET WEST STE. A, KIMBERLY, ID 83341
(208) 423-5001
(208) 423-4867
Mailing address
610 GARNET DR, KIMBERLY, ID 83341-1942
(505) 787-0082
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3277
NM
Other
Enumeration date
04/15/2008
Last updated
01/28/2022
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