| Roy S. Shelburne, Dds, Ltd | |
| 
					153 E Morgan Ave Pennington Gap VA 24277-2643  | |
| (276) 546-2042 | |
| (276) 546-3029 | 
| Full Name | Roy S. Shelburne, Dds, Ltd | 
|---|---|
| Speciality | Dentist | 
| Location | 153 E Morgan Ave, Pennington Gap, Virginia | 
| Authorized Official Name and Position | Roy Silas Shelburne (PRESIDENT) | 
| Authorized Official Contact | 2765462042 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Roy S. Shelburne, Dds, Ltd 153 E Morgan Ave Pennington Gap VA 24277-2643 Ph: (276) 546-2042  | Roy S. Shelburne, Dds, Ltd 153 E Morgan Ave Pennington Gap VA 24277-2643 Ph: (276) 546-2042  | 
| NPI Number | 1992826804 | 
|---|---|
| Provider Enumeration Date | 04/02/2007 | 
| Last Update Date | 08/22/2020 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1992826804 | NPI | - | NPPES | 
| 9177403 | Medicaid | VA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 122300000X | Dentist | 0401-005798 (Virginia) | Primary | 
Lee Family Dental Plc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 153 E Morgan Ave, Pennington Gap, VA 24277 Phone: 276-546-2042 Fax: 276-546-3029  |