Individual
JENEEN RENEE SHEPHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
630 36TH ST SW, WYOMING, MI 49509-4100
(616) 538-9030
Mailing address
630 36TH ST SW, WYOMING, MI 49509-4100
(616) 538-9020
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DEN4913
ME
1223G0001X
General Practice Dentistry
Primary
2901601163
MI
Other
Enumeration date
05/03/2021
Last updated
03/02/2023
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