Individual
DR. MICHAEL K SHROUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1459 LANEY WALKER BLVD, AD1501, AUGUSTA, GA 30912-0002
(706) 721-0502
(706) 721-6778
Mailing address
1459 LANEY WALKER BLVD, AD1501, AUGUSTA, GA 30912-0002
(706) 721-0502
(706) 721-6778
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DNF000206
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZG0206
—
SC
Enumeration date
05/25/2006
Last updated
07/09/2007
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