Individual
DR. GARY R SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4103 BRIDGEPORT WAY W, STE A, UNIVERSITY PLACE, WA 98466-4300
(253) 565-4474
(253) 565-6848
Mailing address
4103 BRIDGEPORT WAY W, STE A, UNIVERSITY PLACE, WA 98466-4300
(253) 565-4474
(253) 565-6848
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE 00006436
WA
Other
Enumeration date
07/30/2008
Last updated
07/30/2008
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