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Individual

DR. JACOB TEEL SHELBURNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
616 CAMPUS DR STE 100, ABINGDON, VA 24210-9706
(276) 525-4487
Mailing address
39 FOREST LODGE DR, LEBANON, VA 24266-6189

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401417476
VA

Other

Enumeration date
06/24/2021
Last updated
06/24/2021
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