Individual
DR. CLINT TYLER SHELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4861 LOGISTICS AVE, FORT BRAGG, NC 28310-0001
(910) 907-9060
Mailing address
4861 LOGISTICS AVE, FORT BRAGG, NC 28310-0001
(910) 907-9060
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
7066379-9921
UT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7066379-9921
UT
Other
Enumeration date
09/12/2008
Last updated
05/18/2021
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