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Individual

DR. DALE DAWSON SHAHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
636 HAMPSHIRE ST STE 102, QUINCY, IL 62301-3054
(217) 228-0101
(217) 222-7011
Mailing address
636 HAMPSHIRE ST STE 102, QUINCY, IL 62301-3054
(217) 228-0101
(217) 222-7011

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019.013067
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021.000729
IL

Other

Enumeration date
09/21/2009
Last updated
09/21/2009
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