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General NPI Number Information
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NPI Number | 1821225707
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Entity Type | Individual
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Provider Name | SHELLI SNIPES TIMM RDH
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Gender | Female
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Dates
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Enumeration Date | 06/17/2009
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Last Update Date | 06/17/2009
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Provider Practice Location Address
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Address Line | 6606 FM 1488 RD STE. 136
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City | MAGNOLIA
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State | TX
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Zip | 77354-2544
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Country | US
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Telephone | 936-273-9399
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Fax |
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Provider Business Mailing Address
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Address Line | 38 S BURBERRY PARK CIR
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City | THE WOODLANDS
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State | TX
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Zip | 77382-5430
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Country | US
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Telephone | 281-806-9977
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 14928
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License Number State | TX
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