Individual
BROOKE ELIZABETH SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1100 S DIXIE BLVD, RADCLIFF, KY 40160-1105
(270) 351-5858
(270) 351-6079
Mailing address
1100 S DIXIE BLVD, RADCLIFF, KY 40160-1105
(270) 351-5858
(270) 351-6079
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10172
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10172
DENTAL LICENSE
KY
Enumeration date
07/31/2018
Last updated
12/08/2020
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