Provider Demographics
NPI:1093360794
Name:DR. DREW SHABO LLC
Entity Type:Organization
Organization Name:DR. DREW SHABO LLC
Other - Org Name:SHABO DENTAL SMILE STUDIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ANALYSTS, REVENUE CYCLE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-241-1931
Mailing Address - Street 1:1309 PANORAMA DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4770
Mailing Address - Country:US
Mailing Address - Phone:423-894-4084
Mailing Address - Fax:
Practice Address - Street 1:1309 PANORAMA DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-4770
Practice Address - Country:US
Practice Address - Phone:423-894-4084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty