Provider Demographics
NPI:1437585627
Name:SHAHEEN, LOUIS A (DDS, PLC)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:A
Last Name:SHAHEEN
Suffix:
Gender:M
Credentials:DDS, PLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:G9171 NORTH SAGINAW ST.
Mailing Address - Street 2:P.O. BOX 247
Mailing Address - City:MT. MORRIS
Mailing Address - State:MI
Mailing Address - Zip Code:48458
Mailing Address - Country:US
Mailing Address - Phone:810-687-3010
Mailing Address - Fax:810-687-1228
Practice Address - Street 1:G9171 NORTH SAGINAW ST.
Practice Address - Street 2:
Practice Address - City:MT. MORRIS
Practice Address - State:MI
Practice Address - Zip Code:48458
Practice Address - Country:US
Practice Address - Phone:810-687-3010
Practice Address - Fax:810-687-1228
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI014184122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist