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Individual

DR. SHAMIR SEVILLA PEREZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
110 S VISITING EAGLE ST, NIOBRARA, NE 68760-7201
(402) 857-2902
(402) 857-2315
Mailing address
110 S. VISITING EAGLE ST., NIOBRARA, NE 68760
(402) 857-2902
(402) 857-2315

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
27490
TX
1223G0001X
General Practice Dentistry
Primary
60957
CA

Other

Enumeration date
01/30/2012
Last updated
01/30/2012
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