Individual
MICHAEL G SHANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
350 GARFIELD ST, LANDER, WY 82520-3124
(307) 332-3181
(307) 332-3484
Mailing address
350 GARFIELD ST, LANDER, WY 82520-3124
(307) 332-3181
(307) 332-3484
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
926
WY
Other
Enumeration date
07/18/2007
Last updated
07/18/2007
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