NPI 1235307828

Mandie Shea Moon Dore, RDHBS

Practitioner Dental Hygienist Coppell, TX

Practice location

Address: 120 S Denton Tap Rd, Coppell, TX 75019-3297
Phone: (469) 635-1105
Fax: (972) 316-6029

Registered specialties

Dental Hygienist Primary

Dental Providers Taxonomy 124Q00000X Licence 13777 (TX)

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Registry record

NPI: 1235307828
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 Feb 2008
Record last updated: 15 Feb 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.