MEDICARE: DR. STANLEY W. SHEFTALL,JR. D.M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	SC2891	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316076292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STANLEY W. SHEFTALL,JR. D.M.D

Provider Business Mailing Address
First Line	:	272 KELLER RD
Second Line	:
City	:	HARTWELL
State	:	GA
Zip	:	30643-4270
Country	:	US
Telephone Number	:	706-371-4052
Fax Number	:

Provider Business Practice Location Address
First Line	:	3620 E RIVER ST
Second Line	:
City	:	ANDERSON
State	:	SC
Zip	:	29621-7334
Country	:	US
Telephone Number	:	864-261-3132
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1548363591 — EASTSIDE FAMILY DENTISTRY PA
Practice Location Address:

3620 EAST RIVER ST
ANDERSON, SC
29621-7334

Practice Phone: 864-261-3132
Practice Fax: 864-261-6614

1144309469 — CLIFTON WAYNE WICKISER D.C.
Practice Location Address:

3618 E RIVER ST
ANDERSON, SC
29621-7334

Practice Phone: 864-224-0246
Practice Fax: 864-224-2524

1215158548 — DMX IMAGING OF ANDERSON
Practice Location Address:

3618 E RIVER ST
ANDERSON, SC
29621-7334

Practice Phone: 864-224-0283
Practice Fax:

1346456498 — WICKISER CLINIC OF CHIROPRACTIC
Practice Location Address:

3618 E RIVER ST
ANDERSON, SC
29621-7334

Practice Phone: 864-224-0246
Practice Fax: 864-224-2524

1639432990 — EASTSIDE FAMILY DENTAL CARE, LLC
Practice Location Address:

3620 E RIVER ST
ANDERSON, SC
29621-7334

Practice Phone: 864-261-3132
Practice Fax:

1053740852 — WICKISER REHAB & WELLNESS LLC
Practice Location Address:

3618 E RIVER ST
ANDERSON, SC
29621-7334

Practice Phone: 864-224-0246
Practice Fax: 864-224-2524

Directions to “ DR. STANLEY W. SHEFTALL,JR. D.M.D” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.