Shanley, Melvin Lee

Shanley, Melvin Lee is an sole proprietor health care provider with primary practice located at 4315 Moonlight Way Suite 101, San Antonio TX 78230-1688. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Shanley, Melvin Lee can be contacted via phone (210) 697-7377.

Contact Information

Primary practice address
4315 Moonlight Way Suite 101 San Antonio TX 78230-1688
Fax: (210) 697-7319
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X TX15668 Texas

Profile Details

NPI number 1679515357
LBN Legal business name Shanley, Melvin Lee
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 10th, 2006
Last updated Apr 30th, 2012 - about 12 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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Identifiers

StateTypeNumberIssuer
All States NPI 1679515357 NPPES
Texas MEDICAID 008956701

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