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Individual

SHANNON SAWYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D

Contact information

Practice address
7802 TIMBERLAKE RD, LYNCHBURG, VA 24502-2602
(434) 239-6948
Mailing address
7802 TIMBERLAKE RD, LYNCHBURG, VA 24502-2602
(434) 239-6948

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0401412529
VA
1223P0221X
Pediatric Dentistry
DS038620
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008214166
VA
01
15487
DORAL
VA
Enumeration date
06/17/2009
Last updated
05/31/2013
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