Individual
MRS. SHELLY PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
500 KENNEDY DR, RANGELY, CO 81648-3502
(970) 675-3245
Mailing address
905 COUNTY ROAD 101, RANGELY, CO 81648-2034
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
000903508
CO
Other
Enumeration date
12/07/2017
Last updated
06/16/2018
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