Individual
DR. JILLIAN LAVERNE SHUTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
US DENTAC HEALTH ACTIVITY FORT CAVAZOS, 36000 SHOEMAKER LANE, SUITE 1051, FORT CAVAZOS, TX 76544-5054
(254) 287-2705
Mailing address
US DENTAC HEALTH ACTIVITY FORT CAVAZOS, 36000 SHOEMAKER LANE, SUITE 1051, FORT CAVAZOS, TX 76544-5054
(785) 239-7927
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
32580
TX
1223G0001X
General Practice Dentistry
63558
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
32580
TX
Other
Enumeration date
11/14/2014
Last updated
05/24/2023
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