Individual
DR. GARY MICHAEL SHELLERUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, PERIODONTIST
Contact information
Practice address
508 W 6TH AVE STE 208, SPOKANE, WA 99204-2730
(509) 838-4321
(509) 838-4618
Mailing address
4309 E SILVER SPUR LN, SPOKANE, WA 99217-9321
(509) 467-2407
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
00005678
WA
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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