Provider Demographics
NPI:1225210545
Name:SHELLING, ROBERT J (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:SHELLING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19615 STATE ROAD 7 STE 33
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-4700
Mailing Address - Country:US
Mailing Address - Phone:561-477-4844
Mailing Address - Fax:561-750-1021
Practice Address - Street 1:19615 STATE ROAD 7 STE 33
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-4700
Practice Address - Country:US
Practice Address - Phone:561-477-4844
Practice Address - Fax:561-750-1021
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN171921223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006715800Medicaid