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NPI Code Detail

MEDICARE: DR. SHARON ELIZABETH MOLITORIS DDS

MEDICARE: DR. SHARON ELIZABETH MOLITORIS DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist019027912IL
21223D0001XPublic Health Dentistry019027912IL

General Provider Information

NPI Number : 1881823011
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHARON ELIZABETH MOLITORIS DDS
Provider Business Mailing Address
First Line : PO BOX 19639
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62794-9639
Country : US
Telephone Number : 217-545-8000
Fax Number : 844-470-2486
Provider Business Practice Location Address
First Line : 109 3RD ST
Second Line :
City : LINCOLN
State : IL
Zip : 62656-2604
Country : US
Telephone Number : 217-735-2317
Fax Number : 217-732-6943
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2009
Last Update Date : 05/10/2024

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