Organization
UP VALLEY ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEN SHANAHAN DDS (PARTNER)
(707) 255-0555
Entity
Organization
Contact information
Practice address
176 MAIN ST STE A, SAINT HELENA, CA 94574-2108
(707) 963-1203
Mailing address
176 MAIN ST STE A, SAINT HELENA, CA 94574-2108
(707) 963-1203
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
05/16/2016
Last updated
05/16/2016
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