DR. Kelvin L. Shane, D.D.S.

NPI #1154733095 in Hudson, Wisconsin

Provider Information

NPI Number: 1154733095
Entity Type: Individual
Name: DR. Kelvin L. Shane, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: May 27, 2014
Last Updated: Apr 17, 2019

Practice Location

Address: 108 WALNUT STREET
Address 2: SUITE A
City: Hudson
State: Wisconsin
ZIP Code: 54016
Phone: (715) 386-2133

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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