Provider Demographics
NPI:1942340138
Name:SCHWAMBURGER, JOHN O'GENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:O'GENE
Last Name:SCHWAMBURGER
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 1:11519 GALLIA PIKE RD
Mailing Address - Street 2:P.O. BOX 486
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694-7901
Mailing Address - Country:US
Mailing Address - Phone:740-574-8270
Mailing Address - Fax:740-574-8270
Practice Address - Street 1:11519 GALLIA PIKE RD
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-7901
Practice Address - Country:US
Practice Address - Phone:740-574-8270
Practice Address - Fax:740-574-8270
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-01-47941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice