Individual
RAYMOND ANTHONY SHELKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1090 GOAT SPRINGS ROAD, TAOS, NM 87571-1946
(575) 758-4224
(575) 751-5210
Mailing address
1090 GOAT SPRINGS ROAD, TAOS, NM 87571-1946
(575) 758-4224
(575) 751-5210
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8722
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49382861
—
NM
05
—
K3543
—
NM
Enumeration date
03/08/2007
Last updated
03/01/2013
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