| Shane A Wilson, | |
|
110 Watson Cir, Gravois Mills, MO 65037-4625 | |
| (763) 528-5539 | |
| Not Available |
| Full Name | Shane A Wilson |
|---|---|
| Gender | Male |
| Speciality | Dentist |
| Location | 110 Watson Cir, Gravois Mills, Missouri |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780334664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2022019208 (Missouri) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Shane A Wilson, 110 Watson Cir, Gravois Mills, MO 65037-4625 Ph: (763) 528-5539 | Shane A Wilson, 110 Watson Cir, Gravois Mills, MO 65037-4625 Ph: (763) 528-5539 |
Mark A Handley, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 401 N Main St, Gravois Mills, MO 65037 Phone: 877-406-2662 Fax: 573-207-2773 | |
Dr. Freddie Ramos, DMD Dentist Medicare: Medicare Enrolled Practice Location: 401 N Main St, Gravois Mills, MO 65037 Phone: 877-406-2662 Fax: 573-207-2773 |