Individual
MRS. SHANNON MARIA PICKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
318 S JEFFERSON ST, MACON, MS 39341-2716
(662) 726-4344
Mailing address
2110 43RD ST, MERIDIAN, MS 39305-2762
(601) 616-8383
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
382209DH
MS
Other
Enumeration date
06/28/2010
Last updated
06/28/2010
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