Individual
DR. COURTNEY W SHELBOURNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
198 RUTLEDGE AVE, SUITE 4, CHARLESTON, SC 29403-5817
(843) 853-5859
(843) 853-5861
Mailing address
198 RUTLEDGE AVE, SUITE 4, CHARLESTON, SC 29403-5817
(843) 853-5859
(843) 853-5861
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3426
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9641
—
SC
Enumeration date
08/02/2005
Last updated
01/25/2013
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