Individual
DR. SHANNEN DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
1001409-15
WI
122300000X
Dentist
DN0160003
GA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN016003
GA
Other
Enumeration date
05/07/2017
Last updated
08/07/2020
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