Individual
SHANE MARCUS PAAP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH, EPDH
Contact information
Practice address
20516 ROBAL LN STE 100, BEND, OR 97701-6703
(541) 797-6331
Mailing address
21078 THOMAS DR, BEND, OR 97702-2455
(541) 408-4784
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H7842
OR
Other
Enumeration date
09/19/2019
Last updated
09/19/2019
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