Individual
ELLIOT SHAMBEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2930 COUNTY HWY NN, WEST BEND, WI 53095-2186
(262) 338-8704
Mailing address
2930 COUNTY HWY NN, WEST BEND, WI 53095
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6001215-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2023
Last updated
06/26/2023
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