Williams, Shane Anthony

Williams, Shane Anthony is an sole proprietor health care provider with primary practice located at 1802 Rockingham Ave , Bowling Green KY 42104-3348. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Pathology, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Williams, Shane Anthony can be contacted via phone (270) 783-0064.

Contact Information

Primary practice address
1802 Rockingham Ave Bowling Green KY 42104-3348
Phone: (270) 783-0064
Fax: (270) 901-1997
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Pathology 1223P0106X 9943 Kentucky
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 332 Oklahoma
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 9422 Tennessee
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 9943 Kentucky

Profile Details

NPI number 1437315272
LBN Legal business name Williams, Shane Anthony
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 31st, 2008
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437315272 NPPES
Tennessee MEDICAID 1528342

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