Provider Demographics
NPI:1619013539
Name:SHILMOVER, ADRIANE KILAR (DMD)
Entity Type:Individual
Prefix:DR
First Name:ADRIANE
Middle Name:KILAR
Last Name:SHILMOVER
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 1:20117 NORMAN COLONY RD
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-7146
Mailing Address - Country:US
Mailing Address - Phone:201-306-1944
Mailing Address - Fax:
Practice Address - Street 1:3010 BAUCOM RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0983
Practice Address - Country:US
Practice Address - Phone:704-697-1223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA221011223G0001X
NC12275122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice