Shine Dental LLC

NPI #1609218114 in Hobbs, New Mexico

Provider Information

NPI Number: 1609218114
Entity Type: Organization
Organization Name: Shine Dental LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 24, 2013
Last Updated: Jul 24, 2013

Practice Location

Address: 2400 N GRIMES ST
Address 2: SUITE B8
City: Hobbs
State: New Mexico
ZIP Code: 88240-2132
Phone: (630) 788-3095

Authorized Official

Name: MR. SRINIVASA R SIRIGIRI
Title: CHAIRMAN
Phone: (630) 788-3095

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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