| John Shea D.d.s. Llc | |
|
615 10th St S La Crosse WI 54601-4768 | |
| (608) 782-4054 | |
| (608) 782-2198 |
| Full Name | John Shea D.d.s. Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 615 10th St S, La Crosse, Wisconsin |
| Authorized Official Name and Position | John V.e. Shea (OWNER) |
| Authorized Official Contact | 6087824054 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John Shea D.d.s. Llc 615 10th St S La Crosse WI 54601-4768 Ph: (608) 782-4054 | John Shea D.d.s. Llc 615 10th St S La Crosse WI 54601-4768 Ph: (608) 782-4054 |
| NPI Number | 1942470331 |
|---|---|
| Provider Enumeration Date | 03/03/2008 |
| Last Update Date | 03/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942470331 | NPI | - | NPPES |
| 33463300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (Wisconsin) | Primary |
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