Individual
DR. THEA DIANE SHIVE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
565 PLANDOME RD, #141, MANHASSET, NY 11030-1945
(516) 330-4430
(516) 624-8317
Mailing address
565 PLANDOME RD, #141, MANHASSET, NY 11030-1945
(516) 330-4430
(516) 624-8317
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
038527
NY
Other
Enumeration date
11/18/2005
Last updated
07/08/2007
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