Individual
SHANNON SMITH WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 772-8160
(502) 772-8108
Mailing address
PO BOX 950244, LOUISVILLE, KY 40295-0244
(502) 953-4700
(502) 772-8189
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9585
KY
Other
Enumeration date
06/10/2015
Last updated
01/25/2023
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