| Gary M Shellerud Dds | |
|
508 W 6th Ave Ste 208 Spokane WA 99204-2730 | |
| (509) 838-4321 | |
| (509) 838-4618 |
| Full Name | Gary M Shellerud Dds |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 508 W 6th Ave Ste 208, Spokane, Washington |
| Authorized Official Name and Position | Gary M Shellerud (OWNER) |
| Authorized Official Contact | 5098384321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary M Shellerud Dds 508 W 6th Ave Ste 208 Spokane WA 99204-2730 Ph: (509) 838-4321 | Gary M Shellerud Dds 508 W 6th Ave Ste 208 Spokane WA 99204-2730 Ph: (509) 838-4321 |
| NPI Number | 1104372556 |
|---|---|
| Provider Enumeration Date | 08/26/2016 |
| Last Update Date | 08/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104372556 | NPI | - | NPPES |
| 1124163068 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 5678 (Washington) | Primary |
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