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Individual

SHADI MOHEBI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1715 BROADMOOR DR STE A, CHAMPAIGN, IL 61821-5984
(217) 886-8217
Mailing address
4008 TURNBERRY DR, CHAMPAIGN, IL 61822-8512
(216) 835-6067

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DL15906
MA

Other

Enumeration date
07/20/2024
Last updated
07/20/2024
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