Individual
SHANE REX TOLLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1719 S LOOP 288 STE 110, DENTON, TX 76205-4810
(940) 735-1102
Mailing address
1719 S LOOP 288 STE 110, DENTON, TX 76205-4810
(940) 735-1102
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
23430
TX
Other
Enumeration date
06/01/2009
Last updated
06/01/2009
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