Individual
AKELY SHIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DENTAL ASSISTANT
Contact information
Practice address
BLDG 171, 4TH & INNER LOOP ROAD, FORT IRWIN, CA 92310
(719) 526-5537
Mailing address
BLDG 171, 4TH & INNER LOOP ROAD, FORT IRWIN, CA 92310
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
11/13/2017
Last updated
11/13/2017
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