Shall, Stephen Mark

Shall, Stephen Mark is an individual health care provider with primary practice located at 5690 Monroe St , Sylvania OH 43560-2736. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery is his primary health care specialty. Shall, Stephen Mark can be contacted via phone (419) 479-3939.

Contact Information

Primary practice address
5690 Monroe St Sylvania OH 43560-2736
Phone: (419) 479-3939
Fax: (419) 479-3933
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 16634 Ohio
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 30.016634 Ohio

Profile Details

NPI number 1215932504
LBN Legal business name Shall, Stephen Mark
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2005
Last updated Aug 1st, 2019 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1215932504 NPPES
Ohio MEDICAID 0515599

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