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General NPI Number Information
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NPI Number | 1609823327
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Entity Type | Organization
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Legal Business Name | LOUIS A SHAHEEN DDS PLC
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | G 9115 NORTH SAGINAW
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City | MT MORRIS
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State | MI
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Zip | 48458
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Country | US
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Telephone | 810-687-3010
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Fax | 810-687-1228
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Provider Business Mailing Address
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Address Line | PO BOX 247
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City | MT MORRIS
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State | MI
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Zip | 48458
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Country | US
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Telephone | 810-687-3010
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Fax | 810-687-1228
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Authorized Official
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Title or Position | A SINGLE MEMBER
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Name | DR. LOUIS ANTHONY SHAHEEN
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Credential | DDS
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Telephone | 810-687-3010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 14184
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License Number State | MI
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