Individual
AMELIA SHIPMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
020015213
IL
124Q00000X
Dental Hygienist
Primary
2017005949
MO
Other
Enumeration date
08/17/2018
Last updated
08/17/2018
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