Individual
DR. JONATHAN JOSEPH SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
6386 ALVARADO CT STE 110, SAN DIEGO, CA 92120
(619) 287-5000
Mailing address
6386 ALVARADO CT STE 110, SAN DIEGO, CA 92120-4906
(619) 287-5000
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
9172
KY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
A153454
CA
208600000X
Surgery Physician
A153454
CA
Other
Enumeration date
04/04/2012
Last updated
06/29/2018
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