Provider Demographics
NPI:1225716087
Name:PETERS, SHELBY LYNN (PHDHP, RDH)
Entity Type:Individual
Prefix:MRS
First Name:SHELBY
Middle Name:LYNN
Last Name:PETERS
Suffix:
Gender:F
Credentials:PHDHP, RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 HESS AVE
Mailing Address - Street 2:
Mailing Address - City:HELLERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18055-1008
Mailing Address - Country:US
Mailing Address - Phone:484-256-7822
Mailing Address - Fax:
Practice Address - Street 1:1101 NORTHAMPTON ST STE 102
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-4152
Practice Address - Country:US
Practice Address - Phone:484-256-7822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPHDH001354124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist