Individual
MRS. MAUREEN T SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
646 N DIAMOND BAR BLVD, DIAMOND BAR, CA 91765-1037
(909) 861-2661
(909) 861-6951
Mailing address
646 N DIAMOND BAR BLVD, DIAMOND BAR, CA 91765-1037
(909) 861-2661
(909) 861-6951
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
32662
CA
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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