Individual
DR. JONATHAN DAVID SHADBURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
124 GOODVIEW WAY STE B, GALLATIN, TN 37066-4927
(615) 575-3344
Mailing address
124 GOODVIEW WAY STE B, GALLATIN, TN 37066-4927
(615) 575-3344
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
30.025658
OH
1223P0221X
Pediatric Dentistry
Primary
11282
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2018
Last updated
11/15/2023
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