Individual
DR. MIKAELA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2602 18TH AVE, CENTRAL CITY, NE 68826-9761
(308) 946-3059
Mailing address
702 8TH ST, EDGAR, NE 68935-3116
(402) 984-2993
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7818
NE
Other
Enumeration date
05/25/2022
Last updated
05/25/2022
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