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Individual

NICOLAS J. SHANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
N79W14756 APPLETON AVE, SUITE 100, MENOMONEE FALLS, WI 53051-4376
(262) 251-2010
(262) 251-5690
Mailing address
N79W14756 APPLETON AVE, SUITE 100, MENOMONEE FALLS, WI 53051-4376
(262) 251-2010
(262) 251-5690

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5000948-015
WI

Other

Enumeration date
07/27/2006
Last updated
07/08/2007
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