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Individual

ANDREW SHELBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4505 W 6TH ST STE B, LAWRENCE, KS 66049-4895
(785) 841-1188
Mailing address
4505 W 6TH ST STE B, LAWRENCE, KS 66049-4895

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
61599
KS
390200000X
Student in an Organized Health Care Education/Training Program
Primary
RES-30506
IA

Other

Enumeration date
03/08/2017
Last updated
04/29/2026
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