Individual
DR. MICHAEL DEAN SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.S.S.
Contact information
Practice address
315 MAIN ST S, SUITE 302, MINOT, ND 58701-3956
(701) 839-7288
(701) 839-1574
Mailing address
315 MAIN ST S, SUITE 302, MINOT, ND 58701-3956
(701) 839-7288
(701) 839-1574
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
1854
ND
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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