Individual
MRS. SHELLY ELKINS LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHDHP
Contact information
Practice address
3826 JAVALYN CT, SLATINGTON, PA 18080-3822
(610) 657-9244
Mailing address
3826 JAVALYN CT, SLATINGTON, PA 18080-3822
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
PHDHP000713
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHDH000713
PA STATE BOARD OF DENTISTRY
PA
Enumeration date
04/20/2018
Last updated
06/16/2018
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