Individual
DR. KYRA Y SHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
340 BOATNER RD BLDG 2751, EGLIN AFB, FL 32542-1391
(508) 883-8052
Mailing address
4405 WINDLAKE DR, NICEVILLE, FL 32578-4812
(323) 491-9989
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS035916
PA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
56736
CA
Other
Enumeration date
10/24/2005
Last updated
04/19/2023
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