Individual
DR. KATHERINE MAE SHADID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
843 W GLEN AVE, PEORIA, IL 61614-4834
(309) 691-9421
Mailing address
11120 N BROOKHAVEN CT, PEORIA, IL 61615-1009
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.035294
IL
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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