Individual
DR. IMAN SHAHINE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
7770 FRONTAGE RD, CICERO, NY 13039-8600
(315) 458-3088
(315) 458-5382
Mailing address
628 BRADFORD PKWY, DEWITT, NY 13214
(315) 458-3088
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
051526
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02608079
—
NY
Enumeration date
10/12/2005
Last updated
07/08/2007
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