Individual
DR. MISTY L SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 E SUNSHINE ST, SUITE H, SPRINGFIELD, MO 65804-1214
(417) 881-3220
(417) 881-6473
Mailing address
1500 E SUNSHINE ST, SUITE H, SPRINGFIELD, MO 65804-1214
(417) 881-3220
(417) 881-6473
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
015949
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015949
DENTAL LICENSE
MO
01
—
BZ5709386
MO. DEPT. OF HEALTH
MO
Enumeration date
01/08/2007
Last updated
07/08/2007
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