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General NPI Number Information
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NPI Number | 1467623611
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Entity Type | Organization
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Legal Business Name | SHELTON & ASSOCIATES DDS PA
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Dates
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Enumeration Date | 03/17/2008
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 341 HARPER AVENUE
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City | LENOIR
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State | NC
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Zip | 28645
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Country | US
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Telephone | 828-754-5244
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Fax | 828-758-9957
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Provider Business Mailing Address
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Address Line | 341 HARPER AVENUE
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City | LENOIR
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State | NC
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Zip | 28645
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Country | US
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Telephone | 828-754-5244
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Fax | 828-758-9957
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Authorized Official
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Title or Position | OWNER
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Name | DR. VADER SHELTON SR.
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Credential | DDS
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Telephone | 828-754-5244
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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 | 3221
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License Number State | NC
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