Individual
DR. KELVIN L. SHANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
108 WALNUT STREET, SUITE A, HUDSON, WI 54016
(715) 386-2133
(763) 515-3970
Mailing address
108 WALNUT STREET, SUITE A, HUDSON, WI 54016
(715) 386-2133
(763) 515-3970
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1001487-15
WI
122300000X
Dentist
D13373
MN
Other
Enumeration date
05/27/2014
Last updated
04/17/2019
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