Provider Demographics
NPI:1912910308
Name:SHELTON, JR., FRANK WESLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:WESLEY
Last Name:SHELTON, JR.
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 1:411 ANDREWS RD
Mailing Address - Street 2:UNIT 210
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2993
Mailing Address - Country:US
Mailing Address - Phone:919-383-6648
Mailing Address - Fax:919-383-3311
Practice Address - Street 1:411 ANDREWS RD
Practice Address - Street 2:UNIT 210
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2993
Practice Address - Country:US
Practice Address - Phone:919-383-6648
Practice Address - Fax:919-383-3311
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice