Shelton, Godfrey P

Shelton, Godfrey P is an sole proprietor health care provider with primary practice located at 573 Martin Luther King Jr Blvd , Newark NJ 07102-1215. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Shelton, Godfrey P can be contacted via phone (973) 622-3614.

Contact Information

Primary practice address
573 Martin Luther King Jr Blvd Newark NJ 07102-1215
Fax: (973) 792-0820
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DI10706 New Jersey

Profile Details

NPI number 1811977598
LBN Legal business name Shelton, Godfrey P
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 19th, 2006
Last updated Apr 3rd, 2012 - about 14 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 1811977598 NPPES
New Jersey MEDICAID 1281101

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