Provider Demographics
NPI:1144240797
Name:SCHOLES, WILLIAM SHANE (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SHANE
Last Name:SCHOLES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 S MAPLE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-1608
Mailing Address - Country:US
Mailing Address - Phone:208-658-8990
Mailing Address - Fax:208-658-8993
Practice Address - Street 1:1223 S MAPLE GROVE RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-1608
Practice Address - Country:US
Practice Address - Phone:208-658-8990
Practice Address - Fax:208-658-8993
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD3619122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist