Provider Demographics
NPI:1841356920
Name:SHINDOLLAR, DOUGLAS CHARLES (DDS)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:CHARLES
Last Name:SHINDOLLAR
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 1:2318 S ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-7756
Mailing Address - Country:US
Mailing Address - Phone:815-254-8550
Mailing Address - Fax:815-254-8175
Practice Address - Street 1:2318 S ROUTE 59
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-7756
Practice Address - Country:US
Practice Address - Phone:815-254-8550
Practice Address - Fax:815-254-8175
Is Sole Proprietor?:No
Enumeration Date:2006-12-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice