Provider Demographics
NPI:1477866457
Name:SHELTON, FELICITY HOPE (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:FELICITY
Middle Name:HOPE
Last Name:SHELTON
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 MURRAY GUARD DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-3752
Mailing Address - Country:US
Mailing Address - Phone:731-664-9900
Mailing Address - Fax:731-668-0854
Practice Address - Street 1:166 MURRAY GUARD DR
Practice Address - Street 2:SUITE B
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3752
Practice Address - Country:US
Practice Address - Phone:731-664-9900
Practice Address - Fax:731-668-0854
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000086741223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics