Shasta Marie Kellerby, RDH Valid NPI
Individual provider · Dental Hygienist · Rifle, CO
- NPI
- 1417228404
- Type
- Individual (Type 1)
- Primary specialty
- Dental Hygienist
- Specialty group
- Dental Providers
- Taxonomy code
- 124Q00000X
- License number
- 904683 (CO)
- Sex
- Female
- Sole proprietor
- Yes
- Enumerated
- 2012-01-23
- Last updated
- 2012-01-23
Practice location
195 W 14th
Rifle, CO 81650-4700
(970) 625-5200