Provider Demographics
NPI:1235292897
Name:BROWN, SHELTON BENEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHELTON
Middle Name:BENEE
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:2379 WALKER DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-6019
Mailing Address - Country:US
Mailing Address - Phone:678-377-6101
Mailing Address - Fax:678-344-1847
Practice Address - Street 1:2151 FOUNTAIN DR
Practice Address - Street 2:206
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6783
Practice Address - Country:US
Practice Address - Phone:678-344-1888
Practice Address - Fax:678-344-1847
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GADNO123291223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry