Individual
DR. MARY SHAH-COX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
809 W DETWEILLER DR, SUITE 805A, PEORIA, IL 61615-2149
(309) 692-1320
(309) 692-1355
Mailing address
809 W DETWEILLER DR, SUITE 805A, PEORIA, IL 61615-2149
(309) 692-1320
(309) 692-1355
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019-024798
IL
Other
Enumeration date
07/14/2009
Last updated
07/14/2009
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