Provider Demographics
NPI:1629206107
Name:SHELTON, ZACHARY USHER (DDS)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:USHER
Last Name:SHELTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:654 INDIAN SPRINGS CIR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-8463
Mailing Address - Country:US
Mailing Address - Phone:931-273-9747
Mailing Address - Fax:
Practice Address - Street 1:1626 MCARTHUR ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-2522
Practice Address - Country:US
Practice Address - Phone:931-728-0313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9027122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist