Individual
MS. MANDIE SHEA MOON DORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH,BS
Contact information
Practice address
120 S DENTON TAP RD, COPPELL, TX 75019-3297
(469) 635-1105
(972) 316-6029
Mailing address
120 S DENTON TAP RD, COPPELL, TX 75019-3297
(469) 635-1105
(972) 316-6029
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
13777
TX
Other
Enumeration date
02/15/2008
Last updated
02/15/2008
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