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NPI Code Detail

MEDICARE: DR. SHARON LYNN BYDONIE DH

MEDICARE: DR. SHARON LYNN BYDONIE DH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1124Q00000XDental HygienistDH1338NM

General Provider Information

NPI Number : 1033106414
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHARON LYNN BYDONIE DH
Provider Business Mailing Address
First Line : PO BOX 160
Second Line :
City : SHIPROCK
State : NM
Zip : 87420-0160
Country : US
Telephone Number : 505-368-6401
Fax Number : 505-368-6431
Provider Business Practice Location Address
First Line : US HWY 491 N
Second Line :
City : SHIPROCK
State : NM
Zip : 87420
Country : US
Telephone Number : 505-368-6401
Fax Number : 505-368-6431
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 01/09/2008

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