Individual
DR. SHELLESE A KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
907 E COTTONWOOD LN STE 1, CASA GRANDE, AZ 85122-2226
(520) 876-5431
(520) 876-4875
Mailing address
907 E COTTONWOOD LN STE 1, CASA GRANDE, AZ 85122-2226
(520) 876-5431
(520) 876-4875
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6296
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
919871
—
AZ
Enumeration date
04/18/2006
Last updated
06/23/2020
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