Individual
SHAYNE PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
12219 E CENTRAL AVE, WICHITA, KS 67206-2808
(801) 712-3631
Mailing address
12219 E CENTRAL AVE, WICHITA, KS 67206-2808
(801) 712-3631
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
61060
KS
1223E0200X
Endodontics
RES. 3083
OH
Other
Enumeration date
08/31/2011
Last updated
12/12/2022
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