Individual
SHANNAN R MAHLBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3390 QUAIL RIDGE CT, WEST LINN, OR 97068-3692
(503) 505-1335
(503) 723-0621
Mailing address
3390 QUAIL RIDGE CT, WEST LINN, OR 97068-3692
(503) 505-1335
(503) 723-0621
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H3707
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H3707
ODA
OR
Enumeration date
11/05/2008
Last updated
11/05/2008
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