Individual
DR. ALLEN JOHN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1610 LAVISTA RD NE, ATLANTA, GA 30329
(404) 636-4171
Mailing address
1610 LAVISTA RD NE, ATLANTA, GA 30329
(404) 636-4171
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6373
GA
Other
Enumeration date
08/04/2006
Last updated
04/26/2026
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