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Individual

SHANEIKA GOULDBOURNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
1511 CHRISTY DR, JEFFERSON CITY, MO 65101-2854
(573) 632-2777
Mailing address
4900 NW 18TH CT, LAUDERHILL, FL 33313-4125
(954) 982-3733

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2026025306
MO

Other

Enumeration date
06/11/2026
Last updated
06/11/2026
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