Provider Demographics
NPI:1770692931
Name:SHELTON, AUNGENETTA LAPREE (DENTAL HYGIENIST)
Entity type:Individual
Prefix:MS
First Name:AUNGENETTA
Middle Name:LAPREE
Last Name:SHELTON
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 REEF LN APT 205
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-6160
Mailing Address - Country:US
Mailing Address - Phone:205-299-9720
Mailing Address - Fax:
Practice Address - Street 1:1647 TAUSSIG BLVD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23511
Practice Address - Country:US
Practice Address - Phone:757-953-8590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist