King, Shellese A

King, Shellese A is an individual health care provider with primary practice located at 907 E Cottonwood Ln Ste 1 , Casa Grande AZ 85122-2226. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. King, Shellese A can be contacted via phone (520) 876-5431.

Contact Information

Primary practice address
907 E Cottonwood Ln Ste 1 Casa Grande AZ 85122-2226
Phone: (520) 876-5431
Fax: (520) 876-4875
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D6296 Arizona

Profile Details

NPI number 1790740512
LBN Legal business name King, Shellese A
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Jun 23rd, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1790740512 NPPES
Arizona MEDICAID 919871

Popular Providers