Individual
MS. SHAWANDA CAROTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
8321 S. HERMITAGE AVE, CHICAGO, IL 60620-4630
(773) 386-4222
Mailing address
8321 S HERMITAGE AVE, CHICAGO, IL 60620-4630
(773) 386-4222
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020.013060
IL
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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