Provider Demographics
NPI:1457085128
Name:CENTER, SHOSHANA MARGALIT (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHOSHANA
Middle Name:MARGALIT
Last Name:CENTER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3114 PLUM ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4359
Mailing Address - Country:US
Mailing Address - Phone:224-522-2171
Mailing Address - Fax:
Practice Address - Street 1:971 W 18TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-2362
Practice Address - Country:US
Practice Address - Phone:312-971-8528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-10
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019033718122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist