Individual
DR. MICHAEL EUGENE SHAMBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1320 MEDICAL PARK DR, FORT WAYNE, IN 46825-5844
(260) 484-7919
(260) 484-5259
Mailing address
1320 MEDICAL PARK DR, FORT WAYNE, IN 46825-5844
(260) 484-7919
(260) 484-5259
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009044A
IN
Other
Enumeration date
05/12/2007
Last updated
07/08/2007
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