Shandra Patrice Brooks, RDH
Dental Hygienist in Fort Campbell, KY. Individual provider (NPI-1).
NPI number1629427596
StatusActive
Last updated in NPPESJun 10, 2022
Details
- NPI
- 1629427596
- Entity type
- Individual (NPI-1)
- Name
- Ms. Shandra Patrice Brooks
- Credential
- RDH
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 10, 2016
- Certification date
- Jun 7, 2022
- Last updated
- Jun 10, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 124Q00000X | Dental Hygienist | 0000004921 | TN | Yes |
| 124Q00000X | Dental Hygienist | 4921 | TN |
Practice location
Bldg 2441 21st StreetUs Army Dental Activity
Fort Campbell, KY 42223
Phone 270-798-8977 · Fax 270-956-0266
Mailing address
5580 Air Assault And Desert StormFt Campbell, KY 42223
Phone 270-798-6362
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All 18 Dental Hygienist providers in Fort Campbell · All 1,373 providers in Fort Campbell
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