Individual
DR. SHAMSA F KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
6405 GEORGETOWN NORTH BLVD, FORT WAYNE, IN 46815-7007
(260) 485-0583
Mailing address
6405 GEORGETOWN NORTH BLVD # 7007, FORT WAYNE, IN 46815-7007
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013012A
IN
1223G0001X
General Practice Dentistry
12013012A
IN
Other
Enumeration date
07/30/2018
Last updated
04/04/2023
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