# FAMILY DENTAL CARE, CHAD SHAW D.D.S.,P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104950492
- **Authorized official:** DR. CHAD J. SHAW D.D.S. (PRESIDENT)
- **Authorized official phone:** (574) 936-8787

## Contact information

- **Practice address:** 1409 N MICHIGAN ST, PLYMOUTH, IN 46563-1119
- **Practice address phone:** (574) 936-8787
- **Mailing address:** 1409 N MICHIGAN ST, PLYMOUTH, IN 46563-1119
- **Mailing address phone:** (574) 936-8787

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12010465A | IN | Yes |

## Other

- **Enumeration date:** 03/16/2007
- **Last updated:** 08/22/2020