Individual
SHANNON HERRON-GRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2025 S ARIZONA AVE, YUMA, AZ 85364-6549
(928) 782-3685
Mailing address
2025 S ARIZONA AVE, YUMA, AZ 85364-6549
(928) 782-3685
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D011474
AZ
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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