# THE DENTAL VILLAGE OF SHELTON

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922090869
- **Authorized official:** DR. SHIRLEY OLIVIA DANIELS DDS (PRESIDENT)
- **Authorized official phone:** (360) 432-1978

## Contact information

- **Practice address:** 2129 JEFFERSON ST, SHELTON, WA 98584-1927
- **Practice address phone:** (360) 432-1978
- **Practice address fax:** (360) 432-2377
- **Mailing address:** 301 E WALLACE KNEELAND BLVD, STE 224, SHELTON, WA 98584-2985
- **Mailing address phone:** (360) 432-1978
- **Mailing address fax:** (360) 432-2377

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE7922 | WA | Yes |

## Other

- **Enumeration date:** 08/17/2005
- **Last updated:** 08/22/2020