Individual
ERIC WAYNE SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
501 SANFORD ST, DECORAH, IA 52101
(563) 382-2441
(563) 382-6048
Mailing address
501 SANFORD ST, DECORAH, IA 52101
(563) 382-2441
(563) 382-6048
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08156
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1262162
—
IA
Enumeration date
09/21/2006
Last updated
02/01/2017
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