Organization
MONTGOMERY DENTAL ARTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOMINIQUE A SHAMBURGER JR. DDS (MBR)
(334) 356-0228
Entity
Organization
Contact information
Practice address
10650 CHANTILLY PARKWAY, MONTGOMERY, AL 36117
(334) 398-2907
(678) 840-3982
Mailing address
10650 CHANTILLY PKWY, MONTGOMERY, AL 36117-7582
(334) 356-0228
(334) 356-0264
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/22/2016
Last updated
12/17/2024
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