Organization
ANGELA R SHELTON DMD PSC
Active
Other names
Radcliff Family Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA R SHELTON DMD (DENTIST OWNER)
(270) 352-5566
Entity
Organization
Contact information
Practice address
299 WEST LINCOLN TRAIL BLVD, SUITE 102, RADCLIFF, KY 40160
(270) 352-5566
(270) 352-5602
Mailing address
PO BOX 778, RADCLIFF, KY 40159-0778
(270) 352-5566
(270) 352-5602
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7521
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
551702
UNITED CONCORDIA TRICARE
KY
05
—
6000338
—
KY
Enumeration date
09/07/2006
Last updated
07/30/2015
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