Provider Demographics
NPI:1184747578
Name:DEAN H. SHELLER D.D.S., PC
Entity type:Organization
Organization Name:DEAN H. SHELLER D.D.S., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:SHELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:319-352-5281
Mailing Address - Street 1:201 20TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-2017
Mailing Address - Country:US
Mailing Address - Phone:301-352-5281
Mailing Address - Fax:319-352-0097
Practice Address - Street 1:201 20TH ST NW
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:IA
Practice Address - Zip Code:50677-2017
Practice Address - Country:US
Practice Address - Phone:301-352-5281
Practice Address - Fax:319-352-0097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA58621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty