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General NPI Number Information
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NPI Number | 1760779268
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Entity Type | Organization
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Legal Business Name | JON E. SHELL D.D.S.
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Dates
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Enumeration Date | 07/05/2011
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Last Update Date | 07/05/2011
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Provider Practice Location Address
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Address Line | 1106 GLENNHILL LN
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City | SEVIERVILLE
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State | TN
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Zip | 37862-6915
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Country | US
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Telephone | 865-429-4333
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Fax | 865-429-2969
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Provider Business Mailing Address
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Address Line | 1106 GLENNHILL LN
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City | SEVIERVILLE
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State | TN
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Zip | 37862-6915
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Country | US
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Telephone | 865-429-4333
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Fax | 865-429-2969
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | CINDY WATSON
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Credential |
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Telephone | 865-429-4333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DS002876
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License Number State | TN
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