Individual
JEFFREY JOSEPH SHAMBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4341 FLAGSTAFF CV, FORT WAYNE, IN 46815-4400
(260) 493-2432
(260) 969-9272
Mailing address
4341 FLAGSTAFF CV, FORT WAYNE, IN 46815-4400
(260) 493-2432
(260) 969-9272
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010642A
IN
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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