| Dale D. Shahan Dds Ltd | |
|
636 Hampshire Suite 102 Quincy IL 62301 | |
| (217) 228-0101 | |
| (217) 222-7011 |
| Full Name | Dale D. Shahan Dds Ltd |
|---|---|
| Speciality | Dentist |
| Location | 636 Hampshire Suite 102, Quincy, Illinois |
| Authorized Official Name and Position | Dale D. Shahan (OWNER) |
| Authorized Official Contact | 2172280101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dale D. Shahan Dds Ltd 636 Hampshire Suite 102 Quincy IL 62301 Ph: (217) 228-0101 | Dale D. Shahan Dds Ltd 636 Hampshire Suite 102 Quincy IL 62301 Ph: (217) 228-0101 |
| NPI Number | 1114234499 |
|---|---|
| Provider Enumeration Date | 09/08/2010 |
| Last Update Date | 09/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114234499 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019-013067 (Illinois) | Primary |
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