Organization
JOHN SHEA D.D.S. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN V.E. SHEA D.D.S. (OWNER)
(608) 782-4054
Entity
Organization
Contact information
Practice address
615 10TH ST S, LA CROSSE, WI 54601-4768
(608) 782-4054
(608) 782-2198
Mailing address
615 10TH ST S, LA CROSSE, WI 54601-4768
(608) 782-4054
(608) 782-2198
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33463300
—
WI
Enumeration date
03/03/2008
Last updated
03/03/2008
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