Provider Demographics
NPI:1669720405
Name:JAMES V SHAMBURGER, DMD, PC
Entity type:Organization
Organization Name:JAMES V SHAMBURGER, DMD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:VICTOR
Authorized Official - Last Name:SHAMBURGER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:251-968-8789
Mailing Address - Street 1:PO BOX 6307
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36547-6307
Mailing Address - Country:US
Mailing Address - Phone:251-968-8789
Mailing Address - Fax:251-968-6520
Practice Address - Street 1:208 W 19TH AVE
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542
Practice Address - Country:US
Practice Address - Phone:251-968-8789
Practice Address - Fax:251-968-6520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL36321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty