Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANE A WILSON
ActiveSHANE A WILSON is a Dentist healthcare provider located in GRAVOIS MILLS, Missouri. NPI 1780334664 is currently active in the NPPES registry. Verify at CMS.
Dentist · GRAVOIS MILLS, MO
Registration Details
- NPI Number
- 1780334664
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 24, 2022 (4.3794103318214 yrs)
- Last Updated
- Jun 6, 2022
- License
-
2022019208 (MO)
Practice Information
- Address
-
110 WATSON CIRGRAVOIS MILLS, MO, 650374625Browse MO providers · Browse ZIP 65037
- Phone
- 7635285539
- Primary Specialty
-
Dentist
122300000X
Other Dentist Providers in GRAVOIS MILLS, MO
| Name | Credential | NPI |
|---|---|---|
| DR. FREDDIE RAMOS | DMD | 1336121615 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.