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Individual
DR. ROLAND G SHELLIE
Active
Individual
DR. ROLAND G SHELLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9701
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
824603
UNITED CONCORDIA
TX
01
—
9701
BLUECROSSBLUESHIELD
TX
01
—
TX9701
DELTA COMPANIES
TX
Enumeration date
01/20/2007
Last updated
07/09/2007
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