Individual
MYRON F SHUSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3101 BRECKENRIDGE LN, SUITE 4B, LOUISVILLE, KY 40220-2742
(502) 451-1020
(502) 451-9339
Mailing address
3101 BRECKENRIDGE LN, SUITE 4B, LOUISVILLE, KY 40220-2742
(502) 451-1020
(502) 451-9339
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4639
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1377294
UCCI 2ND LOCATION FISCHER
KY
05
—
4503
—
KY
01
—
59258
UCCI BRECKENRIDGE LANE
KY
Enumeration date
11/29/2006
Last updated
07/09/2007
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