Shaw Family Dental SC
Organization Active NPI General Practice Dentistry · Ellsworth, WI
NPI 1396162020 · NPPES record last updated Mar 19, 2014
Key facts
- NPI
- 1396162020
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 5175-015 (WI)
- Legal business name
- SHAW FAMILY DENTAL SC
- Practice address
- 501 W. Lucas Lane
Ellsworth, WI 54011 - Phone
- (715) 273-3700
- Fax
- (715) 273-1700
- NPI assigned
- Mar 19, 2014
- Organization subpart
- No
Authorized official
- Name
- Krisan Shaw
- Title
- Owner
- Phone
- (715) 425-6081
Practitioners 2
-
Krisan Shaw, D.D.S.
-
Kaitlin Knutson, DDS
National Provider Directory
Locations
501 Lucas Ln
Ellsworth, WI 54011
Phone (715) 273-3700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 5175-015 | WI | Yes |
Addresses
Primary practice location
501 W. Lucas Lane
Ellsworth, WI 54011
Mailing address
501 W. Lucas Lane
Ellsworth, WI 54011
Phone (715) 273-3700
Other providers in Ellsworth, WI
- Pierce County Office on Aging
- Jessica Puhrmann
- Julie L Raethke
- Leah Mary Ramos
- Ritzinger Optometric Clinic, S.C.
- Krisan Shaw
- Daniel Richard Sherry
- Shopko Stores Operating Co LLC
- Evangeline Desideria Sigwarth
- Kristie F Simmons
All providers in Ellsworth, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.