# JOHN SHEA D.D.S. LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942470331
- **Authorized official:** JOHN V.E. SHEA D.D.S. (OWNER)
- **Authorized official phone:** (608) 782-4054

## Contact information

- **Practice address:** 615 10TH ST S, LA CROSSE, WI 54601-4768
- **Practice address phone:** (608) 782-4054
- **Practice address fax:** (608) 782-2198
- **Mailing address:** 615 10TH ST S, LA CROSSE, WI 54601-4768
- **Mailing address phone:** (608) 782-4054
- **Mailing address fax:** (608) 782-2198

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | WI | Yes |

## Other

- **Enumeration date:** 03/03/2008
- **Last updated:** 03/03/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 33463300 | — | WI |