Provider Demographics
NPI:1780738609
Name:SHEDLOSKY, MICHAEL FRANCIS (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FRANCIS
Last Name:SHEDLOSKY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4305 GREEN CLIFFS RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-1244
Mailing Address - Country:US
Mailing Address - Phone:512-454-6744
Mailing Address - Fax:
Practice Address - Street 1:4306 MEDICAL PKWY
Practice Address - Street 2:SUITE 2
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3312
Practice Address - Country:US
Practice Address - Phone:512-454-6744
Practice Address - Fax:512-419-0133
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX211341223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery