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Organization
ROBERT J. SHANAHAN D.D.S., LTD.
Active
Organization
ROBERT J. SHANAHAN D.D.S., LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT J SHANAHAN DENTIST (PRESIDENT)
(708) 783-1100
Entity
Organization
Contact information
Practice address
6686 JOLIET ROAD, INDIAN HEAD PARK, IL 60525
(708) 783-1100
(708) 783-1101
Mailing address
6686 JOLIET RD, INDIAN HEAD PARK, IL 60525
(708) 783-1100
(708) 783-1101
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19013677
IL
Other
Enumeration date
03/12/2009
Last updated
03/12/2009
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