Individual
HEATHER SHUTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
7101 HOFF ST BLDG 9240, USA DENTAL ACTIVITY, FORT BENNING, GA 31905-5645
(706) 544-3103
(706) 544-1933
Mailing address
7101 HOFF ST BLDG 9240, USA DENTAL ACTIVITY, FORT BENNING, GA 31905-5645
(706) 544-3103
(706) 544-1933
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH011499
GA
124Q00000X
Dental Hygienist
H.007822-C1
AL
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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