Individual
SHELBY THOMAS JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
215 S POWER RD STE 101, MESA, AZ 85206-5236
(480) 981-8698
Mailing address
1959 S POWER RD STE 103-190, MESA, AZ 85206-3768
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D010715
AZ
Other
Enumeration date
05/20/2016
Last updated
08/20/2021
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