Provider Demographics
NPI:1245391382
Name:SHIMBORSKI, ROBERT J (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:SHIMBORSKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 W MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-2130
Mailing Address - Country:US
Mailing Address - Phone:215-757-2151
Mailing Address - Fax:215-757-6341
Practice Address - Street 1:123 W MAPLE AVE
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-2130
Practice Address - Country:US
Practice Address - Phone:215-757-2151
Practice Address - Fax:215-757-6341
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020424L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice