Individual
SHELLIE ANN GODINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
422 N BENTON ST, MILLERSBURG, IN 46543-9732
(574) 642-4449
Mailing address
58724 FAWN RIVER CT, ELKHART, IN 46516-6200
(574) 238-5470
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12011803A
IN
Other
Enumeration date
02/26/2013
Last updated
07/21/2022
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