Shelley Dental, Inc
Organization Active NPI General Practice Dentistry · Shelley, ID
NPI 1174775902 · NPPES record last updated Oct 10, 2008
Key facts
- NPI
- 1174775902
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Legal business name
- SHELLEY DENTAL, INC
- Practice address
- 530 S State St
Shelley, ID 83274 - Phone
- (208) 357-2400
- Fax
- (208) 357-2414
- NPI assigned
- Oct 10, 2008
- Organization subpart
- No
Authorized official
- Name
- John R Stohl
- Title
- Owner
- Phone
- (208) 357-2400
Practitioners 1
National Provider Directory
Locations
530 S State St
Shelley, ID 83274
Phone (208) 357-2400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | Yes |
Addresses
Primary practice location
530 S State St
Shelley, ID 83274
Mailing address
530 S State St
Shelley, ID 83274
Phone (208) 357-2400
Other providers in Shelley, ID
- Shawn Satterthwaite
- Daniel Schauwecker
- Randall Searle
- Dayne F Shaw
- Shelley Chiropractic, P.a.
- Shelley-Firth Quick Response Unit
- Samuel R Smith
- Snake River Eye Associates of Shelley, PLLC
- Aubrey Joy Snell
- Kristan C Sparks
All providers in Shelley, ID · General Practice Dentistry in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.