| Shah Dental Clinic,llc | |
|
135 S Sycamore St Centralia IL 62801-3525 | |
| (618) 532-1411 | |
| (618) 532-1496 |
| Full Name | Shah Dental Clinic,llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 135 S Sycamore St, Centralia, Illinois |
| Authorized Official Name and Position | Kianor Shahmohammadi (OWNER) |
| Authorized Official Contact | 6185321411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shah Dental Clinic,llc 135 S Sycamore St P.o. Box 703 Centralia IL 62801-3525 Ph: (618) 532-1411 | Shah Dental Clinic,llc 135 S Sycamore St Centralia IL 62801-3525 Ph: (618) 532-1411 |
| NPI Number | 1669614145 |
|---|---|
| Provider Enumeration Date | 03/31/2009 |
| Last Update Date | 03/31/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669614145 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019027170 (Illinois) | Primary |
Samuel M Smith Dmd Phd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1519 East Mccord St, Centralia, IL 62801 Phone: 618-532-1879 Fax: 618-532-0479 | |
J Franklin Whipps Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1020 Jonas Street, Centralia, IL 62801 Phone: 618-532-1821 Fax: 618-532-1915 |