Organization
DALE D. SHAHAN DDS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE D. SHAHAN DDS (OWNER)
(217) 228-0101
Entity
Organization
Contact information
Practice address
636 HAMPSHIRE SUITE 102, QUINCY, IL 62301
(217) 228-0101
(217) 222-7011
Mailing address
636 HAMPSHIRE SUITE 102, QUINCY, IL 62301
(217) 228-0101
(217) 222-7011
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019-013067
IL
Other
Enumeration date
09/08/2010
Last updated
09/08/2010
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