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Individual

SHELLIE MUNDALL BOYDSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDHAP

Contact information

Practice address
28095 WEST SHORE ROAD, LAKE ARROWHEAD, CA 92352-2924
(909) 480-1730
Mailing address
PO BOX 2924 28095 W. SHORE ROAD, LAKE ARROWHEAD, CA 92352-2924
(909) 480-1730

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
HAP635
CA

Other

Enumeration date
09/07/2016
Last updated
09/07/2016
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