# ANGELA R SHELTON DMD PSC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Radcliff Family Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427151059
- **Authorized official:** DR. ANGELA R SHELTON DMD (DENTIST OWNER)
- **Authorized official phone:** (270) 352-5566

## Contact information

- **Practice address:** 299 WEST LINCOLN TRAIL BLVD, SUITE 102, RADCLIFF, KY 40160
- **Practice address phone:** (270) 352-5566
- **Practice address fax:** (270) 352-5602
- **Mailing address:** PO BOX 778, RADCLIFF, KY 40159-0778
- **Mailing address phone:** (270) 352-5566
- **Mailing address fax:** (270) 352-5602

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 7521 | KY | Yes |

## Other

- **Enumeration date:** 09/07/2006
- **Last updated:** 07/30/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 551702 | UNITED CONCORDIA TRICARE | KY |
| 05 | — | 6000338 | — | KY |