Provider Demographics
NPI:1710144431
Name:SHELLY, ELIZABETH DINCHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:DINCHER
Last Name:SHELLY
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 1:800 MAIN ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-1656
Mailing Address - Country:US
Mailing Address - Phone:843-681-8166
Mailing Address - Fax:843-689-5275
Practice Address - Street 1:800 MAIN ST
Practice Address - Street 2:SUITE 120
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-1656
Practice Address - Country:US
Practice Address - Phone:843-681-8166
Practice Address - Fax:843-689-5275
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2852122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist