Provider Demographics
NPI:1972232973
Name:SHELTON L CHOW, DD, PLLC
Entity Type:Organization
Organization Name:SHELTON L CHOW, DD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SHELTON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-440-1856
Mailing Address - Street 1:75 E RIVULON BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-0005
Mailing Address - Country:US
Mailing Address - Phone:520-440-1856
Mailing Address - Fax:
Practice Address - Street 1:75 E RIVULON BLVD STE 104
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-0005
Practice Address - Country:US
Practice Address - Phone:520-440-1856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental