Provider Demographics
NPI:1538110150
Name:SHONK, WILLIAM K (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:K
Last Name:SHONK
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 1:1540 CONNER ST
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-2914
Mailing Address - Country:US
Mailing Address - Phone:317-773-0883
Mailing Address - Fax:317-770-6070
Practice Address - Street 1:1540 CONNER ST
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2914
Practice Address - Country:US
Practice Address - Phone:317-773-0883
Practice Address - Fax:317-770-6070
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN83301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice