JOHN JACOB SHANK

FORT WAYNE, IN
NPI1154349439
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: IN  12009584)
Enumeration Date2006-07-17
Last Update Date2009-01-27
Business Address
-- JOHN JACOB SHANK DDS
2121 E DUPONT RD STE C
FORT WAYNE, IN 46825-1546
Phone number: 260-490-2013
Mailing Address
-- JOHN JACOB SHANK DDS
2121 E DUPONT RD STE C
FORT WAYNE, IN 46825-1546
Phone number: 260-490-2013
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