Holt, Shalise Marie
Holt, Shalise Marie is an individual health care provider with primary practice located at 4001 N Mulford Rd , Loves Park IL 61111-6949. She recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as her primary health care specialty. Holt, Shalise Marie can be contacted via phone (815) 877-6453.Contact Information
Primary practice address
4001 N Mulford Rd
Loves Park IL 61111-6949
Phone: (815) 877-6453
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 021.002884 | Illinois |
Profile Details
| NPI number | 1164904272 |
|---|---|
| LBN Legal business name | Holt, Shalise Marie |
| Credentials | DDS, MS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 5th, 2018 |
| Last updated | Sep 5th, 2018 - about 8 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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