Provider Demographics
NPI:1922234988
Name:MORIN, SHANNA MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:SHANNA
Middle Name:MARIE
Last Name:MORIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SHANNA
Other - Middle Name:MARIE
Other - Last Name:MCGETTRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6804 MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-2032
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6804 MEADOW CT
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-2032
Practice Address - Country:US
Practice Address - Phone:248-200-9704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN289321223G0001X
MI29010200261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice