| Organization Name: | ENGILMAN ORTHODONTICS - SHELBYVILLE |
| NPI Number: | 1083888978 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHEN JAMES (CFO) |
| Mailing Address: | 1415 Main Street Shelbyville |
| State: | KY US |
| Postal Code: | 400658126 |
| Phone Number: | 5026334613 |
| Fax Number: | 5026330048 |
| NPI Enumeration Date: | 04/22/2008 |
| NPI Last Update Date: | 06/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |