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Organization

SHINE DENTAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SRINIVASA R SIRIGIRI (CHAIRMAN)
(630) 788-3095
Entity
Organization

Contact information

Practice address
2400 N GRIMES ST, SUITE B8, HOBBS, NM 88240-2132
(630) 788-3095
Mailing address
2306 N MULBERRY LN, HOBBS, NM 88240-2545
(630) 788-3095

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
NDO-0010
NM

Other

Enumeration date
07/24/2013
Last updated
07/24/2013
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