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Individual

DR. TANYA LYNN SHORES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
1210 GEORE C. WILSON DR., AUGUSTA, GA 30909-4501
(706) 855-8818
(706) 855-0534
Mailing address
1210 GEORE C. WILSON DR., AUGUSTA, GA 30909-4501
(706) 855-8818
(706) 855-0534

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
8118
SC
122300000X
Dentist
Primary
DN014451
GA

Other

Enumeration date
10/04/2012
Last updated
10/04/2012
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