Organization
RUBY MOUNTAIN DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS TRENT SHEPHERD DMD (DENTIST/OWNER)
(775) 752-3056
Entity
Organization
Contact information
Practice address
1000 HUMBOLDT AVE STE A, WELLS, NV 89835
(775) 752-3056
Mailing address
610 GARNET DR, KIMBERLY, ID 83341-1942
(505) 787-0082
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
GR6862TA
NV
Other
Enumeration date
08/24/2018
Last updated
08/24/2018
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