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General NPI Number Information
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NPI Number | 1225442833
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Entity Type | Individual
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Provider Name | KATIE NAGEL SHAO D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/12/2014
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 600 OLD DUBUQUE RD
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City | ANAMOSA
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State | IA
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Zip | 52205-1337
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Country | US
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Telephone | 319-462-2313
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Fax |
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Provider Business Mailing Address
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Address Line | 600 OLD DUBUQUE RD
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City | ANAMOSA
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State | IA
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Zip | 52205-1337
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Country | US
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Telephone | 319-462-2313
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 09086
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License Number State | IA
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