Provider Demographics
NPI:1063636827
Name:CALLAHAN, WILLIAM SHAWN (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:SHAWN
Last Name:CALLAHAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 CECIL ASHBURN DR SE STE 203
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-2564
Mailing Address - Country:US
Mailing Address - Phone:256-885-0225
Mailing Address - Fax:256-885-0128
Practice Address - Street 1:2045 CECIL ASHBURN DR SE STE 203
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-2564
Practice Address - Country:US
Practice Address - Phone:256-885-0225
Practice Address - Fax:256-885-0128
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5176122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist