Organization
SHEPPARD PERIODONTICS, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY DAWN SHEPPARD DDS (PRESIDENT/PERIODONTIST)
(847) 885-1664
Entity
Organization
Contact information
Practice address
990 GRAND CANYON PKWY, SUITE 320, HOFFMAN ESTATES, IL 60169-1739
(847) 885-1664
(847) 885-1705
Mailing address
990 GRAND CANYON PKWY, SUITE 320, HOFFMAN ESTATES, IL 60169-1739
(847) 885-1664
(847) 885-1705
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
019026359
IL
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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