Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHALISE MARIE HOLT, DDS, MS
ActiveSHALISE MARIE HOLT, DDS, MS is a Orthodontics healthcare provider located in LOVES PARK, Illinois. NPI 1164904272 is currently active in the NPPES registry. Verify at CMS.
Orthodontics · LOVES PARK, IL
Registration Details
- NPI Number
- 1164904272
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 5, 2018 (7.9770786160754 yrs)
- Last Updated
- Sep 5, 2018
- License
-
021.002884 (IL)
Practice Information
- Address
-
4001 N MULFORD RDLOVES PARK, IL, 611116949Browse IL providers · Browse ZIP 61111
- Phone
- 8158776453
- Primary Specialty
-
Orthodontics
1223X0400X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.