Shelley, Clint Tyler

Shelley, Clint Tyler is an individual health care provider with primary practice located at 4861 Logistics Ave , Fort Bragg NC 28310-0001. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Shelley, Clint Tyler can be contacted via phone (910) 907-9060.

Contact Information

Primary practice address
4861 Logistics Ave Fort Bragg NC 28310-0001
Phone: (910) 907-9060
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 7066379-9921 Utah
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 7066379-9921 Utah

Profile Details

NPI number 1922257021
LBN Legal business name Shelley, Clint Tyler
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 12th, 2008
Last updated May 18th, 2021 - about 3 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.

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