Individual
DR. SHANE SIDHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7804 132ND STREET CT E, PUYALLUP, WA 98373-2514
(253) 691-3447
(253) 531-9787
Mailing address
7804 132ND STREET CT E, PUYALLUP, WA 98373-2514
(253) 691-3447
(253) 531-9787
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60061884
WA
Other
Enumeration date
02/12/2009
Last updated
02/12/2009
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