# E. CARL SHAW, DMD, PC

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

## Provider details

- **NPI number:** 1558582726
- **Authorized official:** E. CARL SHAW DMD (PRESIDENT)
- **Authorized official phone:** (478) 923-0253

## Contact information

- **Practice address:** 1267 RUSSELL PKWY, WARNER ROBINS, GA 31088-5582
- **Practice address phone:** (478) 923-0253
- **Mailing address:** 1267 RUSSELL PKWY, WARNER ROBINS, GA 31088-5582
- **Mailing address phone:** (478) 923-0253

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 70952 | GA | Yes |

## Other

- **Enumeration date:** 05/02/2007
- **Last updated:** 08/22/2020