Individual
SHANNON GIRARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
5 OLD NECK RD, SCARBOROUGH, ME 04074-9401
(207) 513-1111
Mailing address
74 ATLANTIC ST, APT 1A, PORTLAND, ME 04101-5400
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3562
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432689899
—
ME
Enumeration date
08/17/2009
Last updated
08/17/2009
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