Individual
DR. GODFREY P SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
573 MARTIN LUTHER KING JR BLVD, NEWARK, NJ 07102-1215
(973) 622-3614
(973) 792-0820
Mailing address
192 PROSPECT AVE, MAYWOOD, NJ 07607-1200
(201) 843-5344
(973) 792-0820
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI10706
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1281101
—
NJ
Enumeration date
01/19/2006
Last updated
04/03/2012
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