Phoenix, Shima
Phoenix, Shima is an individual health care provider with primary practice located at 4201 Broadway St , Mount Vernon IL 62864-2282. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Phoenix, Shima can be contacted via phone (618) 241-0997.Contact Information
Primary practice address
4201 Broadway St
Mount Vernon IL 62864-2282
Phone: (618) 241-0997
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 019.030430 | Illinois |
Profile Details
| NPI number | 1588040976 |
|---|---|
| LBN Legal business name | Phoenix, Shima |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 7th, 2015 |
| Last updated | Aug 20th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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