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General NPI Number Information
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NPI Number | 1093086225
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Entity Type | Organization
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Legal Business Name | SHINE DENTAL ARTS, LLC
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Dates
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Enumeration Date | 01/19/2012
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 9224 TEDDY LN STE 102
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City | LONE TREE
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State | CO
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Zip | 80124-6799
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Country | US
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Telephone | 720-776-9401
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Fax | 303-648-5433
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Provider Business Mailing Address
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Address Line | 9224 TEDDY LN STE 102
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City | LONE TREE
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State | CO
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Zip | 80124-6799
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Country | US
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Telephone | 720-776-9401
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Fax | 303-648-5433
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MS. SHONA LYNN ARMSTRONG
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Credential | RDH
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Telephone | 207-769-4017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | CO-905211
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License Number State | CO
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