Provider Demographics
NPI:1265879902
Name:ALEXANDER, SHELBY ALLISON (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:ALLISON
Last Name:ALEXANDER
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 1:513 PINNACLE HEIGHT DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-8067
Mailing Address - Country:US
Mailing Address - Phone:856-625-0961
Mailing Address - Fax:
Practice Address - Street 1:451 SUNCREST TOWN CENTRE DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-1814
Practice Address - Country:US
Practice Address - Phone:304-293-5831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV4053122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist