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General NPI Number Information
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NPI Number | 1588800791
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Entity Type | Organization
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Legal Business Name | WILLIAM E SHELTON DDS PA
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Dates
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Enumeration Date | 12/18/2008
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Last Update Date | 12/18/2008
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Provider Practice Location Address
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Address Line | 1985 HARRISON ST
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City | BATESVILLE
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State | AR
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Zip | 72501-7309
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Country | US
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Telephone | 870-793-7529
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Fax | 870-793-7867
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Provider Business Mailing Address
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Address Line | 1985 HARRISON ST
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City | BATESVILLE
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State | AR
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Zip | 72501-7309
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Country | US
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Telephone | 870-793-7529
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Fax | 870-793-7867
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | SUSAN L VARNELL
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Credential |
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Telephone | 870-793-7529
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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 | 2286
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License Number State | AR
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