| NPI | 1205361862 |
|---|---|
| Doing Business As | SHANE DENTAL |
| Entity Type | Organization |
| Authorized Contact | KELVIN SHANE Owner 715-386-2133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 100148715) |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2017-04-20 |