NPI 1114309408

Shelby Dene Blaylock, DDS

Practitioner Dentist Olive Branch, MS

Practice location

Address: 9035 E Sandidge Rd STE 100, Olive Branch, MS 38654-3563
Phone: (662) 895-7338
Fax: (662) 895-7040

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 3811-15 (MS)

Other Dentist providers in Mississippi →

Registry record

NPI: 1114309408
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Jun 2015
Record last updated: 23 Jun 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.