Individual
SHANNON DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016
(602) 263-1200
Mailing address
PO BOX 31001-0698, PASADENA, CA 91110-0698
(602) 263-1200
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
6071
AZ
Other
Enumeration date
09/22/2008
Last updated
09/23/2019
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