MEDICARE: DR. MICHAEL FRANCIS SHEDLOSKY 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	21134	TX

General Provider Information

NPI Number	:	1780738609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL FRANCIS SHEDLOSKY DMD

Provider Business Mailing Address
First Line	:	4305 GREEN CLIFFS RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-1244
Country	:	US
Telephone Number	:	512-454-6744
Fax Number	:

Provider Business Practice Location Address
First Line	:	4306 MEDICAL PKWY
Second Line	:	SUITE 2
City	:	AUSTIN
State	:	TX
Zip	:	78756-3312
Country	:	US
Telephone Number	:	512-454-6744
Fax Number	:	512-419-0133

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

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	07/08/2007

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