Individual
DR. ABBY JOANNA SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
59 DG AF POSTGRADUATE DENTAL SCHOOL, 2133 PEPPERRELL ST, BLDG 3352, JBSA-LACKLAND, TX 78236-5313
(210) 292-6258
Mailing address
59 DG AF POSTGRADUATE DENTAL SCHOOL, 2133 PEPPERRELL ST, BLDG 3352, JBSA-LACKLAND, TX 78236-5313
(210) 292-6258
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
08552
IA
Other
Enumeration date
06/26/2008
Last updated
06/18/2021
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