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415 N Gloster St Tupelo MS 38804-3625 | |
| (662) 842-2055 | |
| (662) 680-4787 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 415 N Gloster St, Tupelo, Mississippi |
| Authorized Official Name and Position | Beth Abel Shelton (DENTIST) |
| Authorized Official Contact | 6628422055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
415 N Gloster St Tupelo MS 38804-3625 Ph: (662) 842-2055 | 415 N Gloster St Tupelo MS 38804-3625 Ph: (662) 842-2055 |
| NPI Number | 1467649087 |
|---|---|
| Provider Enumeration Date | 09/27/2007 |
| Last Update Date | 09/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467649087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3103-99 (Mississippi) | Primary |
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