| Shambaugh Dental Group | |
|
4341 Flagstaff Cv Fort Wayne IN 46815-4400 | |
| (260) 493-2432 | |
| (260) 492-2942 |
| Full Name | Shambaugh Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4341 Flagstaff Cv, Fort Wayne, Indiana |
| Authorized Official Name and Position | Jeffrey Joseph Shambaugh (DENTIST/OWNER) |
| Authorized Official Contact | 2604932432 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shambaugh Dental Group 4341 Flagstaff Cv Fort Wayne IN 46815-4400 Ph: (260) 493-2432 | Shambaugh Dental Group 4341 Flagstaff Cv Fort Wayne IN 46815-4400 Ph: (260) 493-2432 |
| NPI Number | 1568838225 |
|---|---|
| Provider Enumeration Date | 08/18/2015 |
| Last Update Date | 08/18/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568838225 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12010642A (Indiana) | Primary |
| 1223G0001X | Dentist - General Practice | 12011943A (Indiana) | Secondary |
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