Provider Demographics
NPI:1073202784
Name:MOTSCHMAN, SHELBY AARON (DDS)
Entity type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:AARON
Last Name:MOTSCHMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9064B FRAZIER ST
Mailing Address - Street 2:
Mailing Address - City:LAUGHLIN AFB
Mailing Address - State:TX
Mailing Address - Zip Code:78840-2705
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:590 MITCHELL BLVD BLDG 375
Practice Address - Street 2:
Practice Address - City:LAUGHLIN AFB
Practice Address - State:TX
Practice Address - Zip Code:78843-5242
Practice Address - Country:US
Practice Address - Phone:830-298-6595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.027125122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist