Individual
RAYANNE F SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2615 ELK DR, STE 3, MINOT, ND 58701-1200
(701) 852-3421
(701) 838-1842
Mailing address
2615 ELK DR, STE 3, MINOT, ND 58701-1200
(701) 852-3421
(701) 838-1842
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1855
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1855
DENTAL LICENSE
ND
05
—
41251
—
ND
Enumeration date
06/20/2006
Last updated
12/14/2010
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