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General NPI Number Information
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NPI Number | 1447092838
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Entity Type | Individual
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Provider Name | BRIAN ALLEN SHELTON DDS
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Gender | Male
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 820 S MUSTANG RD
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City | YUKON
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State | OK
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Zip | 73099-6767
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Country | US
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Telephone | 405-577-2444
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Fax |
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Provider Business Mailing Address
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Address Line | 6231 N UTAH AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-1373
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Country | US
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Telephone | 918-857-6778
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 7858
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License Number State | OK
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