Individual
SHELLEY NELSON WAKEFIELD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
14682 PENNOCK AVE, APPLE VALLEY, MN 55124-7429
(952) 431-5774
Mailing address
1601 HIGHPOINT CURV, BURNSVILLE, MN 55337-3933
(952) 891-4918
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9428
MN
Other
Enumeration date
08/24/2005
Last updated
07/08/2007
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