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:
Health care specialties
| Specialty | Code | License # | 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 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790740512 | NPPES |
| Arizona | MEDICAID | 919871 |
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