Organization
DAYTON DENTAL COLLABORATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
R. GREGORY SHELHOUSE DDS (OWNER DENTIST)
(937) 435-5163
Entity
Organization
Contact information
Practice address
5685 FAR HILLS AVE, DAYTON, OH 45429-2226
(937) 435-5163
(937) 291-9353
Mailing address
5685 FAR HILLS AVE, DAYTON, OH 45429-2226
(937) 435-5163
(937) 291-9353
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15799
OH
Other
Enumeration date
12/09/2008
Last updated
12/09/2008
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