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Individual

SHANETHA LINN COLLIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
610 E 24TH ST, TISHOMINGO, OK 73460-3245
(580) 371-2343
Mailing address
2227 GERSHWIN DR, DURANT, OK 74701-2015
(580) 775-0552

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6476
OK

Other

Enumeration date
05/22/2013
Last updated
05/22/2013
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