Individual
CRYSTAL MAE SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3165 E SPAULDING AVE APT 101, PUEBLO, CO 81008-2243
(307) 399-6186
Mailing address
3165 E. SPAUILDING AVE APT 101, PUEBLO, CO 81008
(307) 399-6186
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
002023652
CO
Other
Enumeration date
02/10/2015
Last updated
02/10/2015
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