Individual
ERIC N SHELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
403 N 5 POINTS RD, WEST CHESTER, PA 19380-4632
(610) 696-3371
(610) 696-5058
Mailing address
403 N 5 POINTS RD, WEST CHESTER, PA 19380-4632
(610) 696-3371
(610) 696-5058
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS026750L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
463481
BLUE SHIELD
PA
Enumeration date
10/18/2006
Last updated
07/08/2007
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