Individual
TRAVIS SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1993 FRONTAGE RD STE 208, SIERRA VISTA, AZ 85635-4695
(520) 458-4646
Mailing address
1137 SENTINEL PEAK RD, SIERRA VISTA, AZ 85635-1496
(509) 844-5518
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D010774
AZ
1223G0001X
General Practice Dentistry
PD0023
AZ
Other
Enumeration date
07/10/2020
Last updated
07/22/2020
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