Individual
S CHAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
650 W BALTIMORE ST, BALTIMORE, MD 21201-1510
(410) 303-6125
Mailing address
1417 NATALIE LN, APT 308, ANN ARBOR, MI 48105-2914
(410) 303-6125
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901021597
MI
Other
Enumeration date
04/15/2014
Last updated
02/14/2019
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