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1144715293
JASON SHOLLY
LACEY, WA
NPI
1144715293
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: WA DE6085544)
Enumeration Date
2018-06-29
Last Update Date
2018-06-29
Business Address
JASON SHOLLY
909 SLEATER KINNEY RD SE STE 3
LACEY, WA 98503-1103
Phone number: 360-491-1414
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Mailing Address
JASON SHOLLY
5401 6TH AVE STE 201
TACOMA, WA 98406-2618
Phone number: 253-759-5437
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