Individual
DR. W. SHANE HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS,MDS
Contact information
Practice address
867 OAKWOOD RD, CHARLESTON, WV 25314-2057
(304) 343-3672
(304) 720-3672
Mailing address
867 OAKWOOD RD, CHARLESTON, WV 25314-2057
(304) 343-3672
(304) 720-3672
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3383
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4002075000
—
WV
Enumeration date
11/15/2006
Last updated
07/09/2007
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