SHANE WILSON

Dentist

Active Individual
NPI: 1780334664

Practice Address

110 WATSON CIR
Gravois Mills, MO 65037

Phone: (763) 528-5539

Specialties

Specialty Code Primary License
Dentist 122300000X Yes 2022019208 (MO)

Frequently Asked Questions

NPI 1780334664 is the National Provider Identifier for SHANE WILSON, a Dentist provider located in Gravois Mills, MO. This NPI was enumerated on March 24, 2022.
SHANE WILSON practices at 110 WATSON CIR, Gravois Mills, MO 65037.

Quick Facts

NPI
1780334664
Type
Individual
Enumerated
Mar 24, 2022
Last Updated
Jun 6, 2022

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