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Individual

CONNOR SHELTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
341 PONCE DE LEON AVE NE, ATLANTA, GA 30308-2012
(404) 616-9770
Mailing address
2108 AUTUMNWOOD DR SW, HARTSELLE, AL 35640-3881
(256) 309-8615

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN123362
GA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/07/2023
Last updated
07/02/2024
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