Individual
DR. THOMAS PATRICK SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.S.
Contact information
Practice address
4320 44TH ST SW, GRANDVILLE, MI 49418-2300
(616) 534-0550
(616) 534-1334
Mailing address
4320 44TH ST SW, NONE, GRANDVILLE, MI 49418-2300
(616) 238-8387
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2901019565
MI
1223G0001X
General Practice Dentistry
4469
SC
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2901019565
MI
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
S47
MN
Other
Enumeration date
06/27/2008
Last updated
08/22/2015
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