Individual
MRS. SHANNON MARIE BURDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2825 SW EAST LOUISE CIR, PORT ST LUCIE, FL 34953-4273
(772) 871-6585
(561) 422-8595
Mailing address
2825 SW EAST LOUISE CIRCLE, PORT ST LUCIE, FL 34953
(772) 871-6585
(561) 422-8595
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
4840
CT
Other
Enumeration date
09/16/2008
Last updated
09/16/2008
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