Individual
DR. SHAWN MICHAEL CUSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3400 W 16TH ST STE 8E, GREELEY, CO 80634-6862
(970) 352-5448
Mailing address
3400 W 16TH ST STE 8E, GREELEY, CO 80634-6862
(970) 352-5448
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
00203394
CO
1223G0001X
General Practice Dentistry
Primary
7363
NE
Other
Enumeration date
05/30/2017
Last updated
05/01/2018
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