Provider Demographics
NPI:1639458334
Name:SHELTON, SUMMER PATTERSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUMMER
Middle Name:PATTERSON
Last Name:SHELTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 859
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:NC
Mailing Address - Zip Code:28128-0859
Mailing Address - Country:US
Mailing Address - Phone:704-474-3153
Mailing Address - Fax:704-474-0274
Practice Address - Street 1:311 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:NC
Practice Address - Zip Code:28128-7429
Practice Address - Country:US
Practice Address - Phone:704-474-3153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9152122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist