# MICHAEL G SHANE DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Michael G Shane DDS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891871471
- **Authorized official:** MICHAEL GEORGE SHANE DDS (PRESIDENT)
- **Authorized official phone:** (307) 332-3181

## Contact information

- **Practice address:** 350 GARFIELD ST, LANDER, WY 82520-3124
- **Practice address phone:** (307) 332-3181
- **Practice address fax:** (307) 332-3484
- **Mailing address:** 350 GARFIELD, LANDER, WY 82520-3124
- **Mailing address phone:** (307) 332-3181
- **Mailing address fax:** (307) 332-3484

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 926 | WY | Yes |

## Other

- **Enumeration date:** 10/27/2006
- **Last updated:** 07/18/2007