Individual
JOHN R. SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
537 S MAIN ST, CENTRAL SQUARE, NY 13036-3500
(315) 676-3001
(315) 676-3785
Mailing address
36 ALDEN AVE, AUBURN, NY 13021-4322
(315) 252-8996
(315) 252-8996
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
035014
NY
Other
Enumeration date
12/19/2006
Last updated
07/08/2007
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