Provider Demographics
NPI:1750492963
Name:SHILLINGBURG, JOHN C (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:SHILLINGBURG
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:3700 FORUMS DR
Mailing Address - Street 2:#203
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1860
Mailing Address - Country:US
Mailing Address - Phone:972-539-1491
Mailing Address - Fax:972-539-3489
Practice Address - Street 1:3700 FORUMS DR
Practice Address - Street 2:#203
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1860
Practice Address - Country:US
Practice Address - Phone:972-539-1491
Practice Address - Fax:972-539-3489
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA04014112931223S0112X
TX199161223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery