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Individual

MRS. SHANDA MAE HAMMOND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH, BS

Contact information

Practice address
1805 HIGHWAY 42, SUITE 120, LOUISVILLE, CO 80027-2505
(303) 666-8820
Mailing address
2779 STAGE COACH DR, MEAD, CO 80542-4021
(303) 514-9344

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
905706
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5638762
CO
Enumeration date
08/09/2013
Last updated
04/14/2016
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