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Individual

DR. PAUL T SHORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
617 JACKSON ST, WAUSAU, WI 54401
(715) 842-0764
Mailing address
617 JACKSON ST, WAUSAU, WI 54403
(715) 842-0764

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5000219015
WI

Other

Enumeration date
08/10/2006
Last updated
07/08/2007
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