Jason Sholly

NPI #1144715293 in Lacey, Washington

Provider Information

NPI Number: 1144715293
Entity Type: Individual
Name: Jason Sholly
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Enumeration Date: Jun 29, 2018
Last Updated: Jun 29, 2018

Practice Location

Address: 909 SLEATER KINNEY RD SE STE 3
City: Lacey
State: Washington
ZIP Code: 98503-1103
Phone: (360) 491-1414

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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