Organization
THE DENTAL VILLAGE OF SHELTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIRLEY OLIVIA DANIELS DDS (PRESIDENT)
(360) 432-1978
Entity
Organization
Contact information
Practice address
2129 JEFFERSON ST, SHELTON, WA 98584-1927
(360) 432-1978
(360) 432-2377
Mailing address
301 E WALLACE KNEELAND BLVD, STE 224, SHELTON, WA 98584-2985
(360) 432-1978
(360) 432-2377
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE7922
WA
Other
Enumeration date
08/17/2005
Last updated
08/22/2020
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