Organization
MELISSA D SHOTELL DMD MS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA D SHOTELL DMD MS (PRESIDENT)
(209) 536-1954
Entity
Organization
Contact information
Practice address
14570 MONO WAY STE I, SONORA, CA 95370-8997
(209) 536-1954
Mailing address
PO BOX 217, SOULSBYVILLE, CA 95372-0217
(209) 536-1954
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
58232
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
58232
CA
Other
Enumeration date
10/02/2015
Last updated
10/02/2015
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