Individual provider · Type 1 NPI
Traci Anne Shambo, RDH
Dental Hygienist · Fort Leonard Wood, MO
Practice location
Bldg. 400 Virginia Ave
Fort Leonard Wood, MO 65473
Mailing address
22964 Revelation Rd
Waynesville, MO 65583-7827
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Hygienist Primary | 124Q00000X | 2012040673 (MO) |
Dental Hygienist: An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and…
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About NPI 1982198453
Traci Anne Shambo, RDH's National Provider Identifier is 1982198453, issued on Jun 19, 2018. The primary taxonomy on file is Dental Hygienist (124Q00000X), and the practice location is in Fort Leonard Wood, MO. The record was last updated on Jun 19, 2018.