| Shambaugh Dental Group | |
|
4616 W Jefferson Blvd Fort Wayne IN 46804-6826 | |
| (260) 432-8596 | |
| Not Available |
| Full Name | Shambaugh Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4616 W Jefferson Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Amanda Rutherford (OFFICE MANAGER) |
| Authorized Official Contact | 2604328596 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shambaugh Dental Group 4616 W Jefferson Blvd Fort Wayne IN 46804-6826 Ph: (260) 432-8596 | Shambaugh Dental Group 4616 W Jefferson Blvd Fort Wayne IN 46804-6826 Ph: (260) 432-8596 |
| NPI Number | 1417326083 |
|---|---|
| Provider Enumeration Date | 09/24/2015 |
| Last Update Date | 05/02/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417326083 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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