MEDICARE: DR. SHANE MICHAEL LANGOLF DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2901019292	MI

General Provider Information

NPI Number	:	1194716670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANE MICHAEL LANGOLF DMD

Provider Business Mailing Address
First Line	:	1616 GRATIOT BLVD
Second Line	:
City	:	MARYSVILLE
State	:	MI
Zip	:	48040-1181
Country	:	US
Telephone Number	:	810-364-7601
Fax Number	:	810-364-9010

Provider Business Practice Location Address
First Line	:	1616 GRATIOT BLVD
Second Line	:
City	:	MARYSVILLE
State	:	MI
Zip	:	48040-1181
Country	:	US
Telephone Number	:	810-364-7601
Fax Number	:	810-364-9010

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1639791585 — PGS D-PROVIDER DENTISTRY PLLC
Practice Location Address:

1616 GRATIOT BLVD
MARYSVILLE, MI
48040-1181

Practice Phone: 586-727-3815
Practice Fax:

1508975319 — BLUE WATER DENTAL GROUP MARYSVILLE PC
Practice Location Address:

1616 GRATIOT BLVD
MARYVILLE, MI
48040-1181

Practice Phone: 810-364-7601
Practice Fax: 810-364-9010

1891274007 — REBECA A TRUMAN
Practice Location Address:

232 N MAIN ST STE 1B
MARYSVILLE, OH
43040-1181

Practice Phone: 937-561-0832
Practice Fax:

1013491893 — TRANQUILITY ACUPUNCTURE, LLC
Practice Location Address:

232 N MAIN ST STE 1B
MARYSVILLE, OH
43040-1181

Practice Phone: 937-561-0832
Practice Fax:

1124974043 — MS. SARAH LOUISE GONDER
Practice Location Address:

195 HURON BLVD
MARYSVILLE, MI
48040-1421

Practice Phone: 989-401-2244
Practice Fax:

1275531022 — DR. ROBERT RAYMOND DEMBOSKY MD
Practice Location Address:

1750 BUSHA HWY
MARYSVILLE, MI
48040-1801

Practice Phone: 810-364-4130
Practice Fax: 810-364-4574

Directions to “ DR. SHANE MICHAEL LANGOLF DMD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.