Individual
STACI LYNN SHIPLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
810 W CHURCH ST, GREENEVILLE, TN 37745-3285
(423) 798-1749
Mailing address
810 W CHURCH ST, GREENEVILLE, TN 37745-3285
(423) 638-1200
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH5801T
TN
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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