Individual
DR. SHELBY DENE BLAYLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
9035 E SANDIDGE RD STE 100, OLIVE BRANCH, MS 38654-3563
(662) 895-7338
(662) 895-7040
Mailing address
9035 E SANDIDGE RD STE 100, OLIVE BRANCH, MS 38654-3563
(662) 895-7338
(662) 895-7040
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3811-15
MS
Other
Enumeration date
06/23/2015
Last updated
06/23/2015
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