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Individual
MICHAEL RICHARD SHELESTAK
Active
Individual
MICHAEL RICHARD SHELESTAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS040096
PA
1223G0001X
General Practice Dentistry
Primary
30024581
OH
1223G0001X
General Practice Dentistry
FS4701428
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
06/11/2014
Last updated
04/09/2021
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