| Shaw Family Dental Sc | |
|
501 W. Lucas Lane Ellsworth WI 54011 | |
| (715) 273-3700 | |
| (715) 273-1700 |
| Full Name | Shaw Family Dental Sc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 501 W. Lucas Lane, Ellsworth, Wisconsin |
| Authorized Official Name and Position | Krisan Shaw (OWNER) |
| Authorized Official Contact | 7154256081 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaw Family Dental Sc 501 W. Lucas Lane Ellsworth WI 54011 Ph: (715) 273-3700 | Shaw Family Dental Sc 501 W. Lucas Lane Ellsworth WI 54011 Ph: (715) 273-3700 |
| NPI Number | 1396162020 |
|---|---|
| Provider Enumeration Date | 03/19/2014 |
| Last Update Date | 03/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396162020 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5175-015 (Wisconsin) | Primary |
Knutson Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Lucas Ln, Ellsworth, WI 54011 Phone: 715-523-9874 |