Individual
MICHELLE SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1040 BROAD ST, SHREWSBURY, NJ 07702-4331
(813) 539-4062
Mailing address
9 SARGENT RD, FREEHOLD, NJ 07728-5903
(120) 140-3750
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
22HI00938400
NJ
Other
Enumeration date
09/03/2021
Last updated
09/03/2021
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