| Shine Dental Llc | |
|
2400 N Grimes St Suite B8 Hobbs NM 88240-2132 | |
| (630) 788-3095 | |
| Not Available |
| Full Name | Shine Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2400 N Grimes St, Hobbs, New Mexico |
| Authorized Official Name and Position | Srinivasa R Sirigiri (CHAIRMAN) |
| Authorized Official Contact | 6307883095 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shine Dental Llc 2306 N Mulberry Ln Hobbs NM 88240-2545 Ph: (630) 788-3095 | Shine Dental Llc 2400 N Grimes St Suite B8 Hobbs NM 88240-2132 Ph: (630) 788-3095 |
| NPI Number | 1609218114 |
|---|---|
| Provider Enumeration Date | 07/24/2013 |
| Last Update Date | 07/24/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609218114 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | NDO-0010 (New Mexico) | Primary |
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