Organization
SHAW & WIEDERHOLD PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIN W SHAW DMD (PRESIDENT)
(270) 926-7272
Entity
Organization
Contact information
Practice address
920 FREDERICA ST, 301, OWENSBORO, KY 42301-3050
(270) 926-7272
Mailing address
920 FREDERICA ST, 301, OWENSBORO, KY 42301-3050
(270) 926-7272
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7760
KY
Other
Enumeration date
02/28/2012
Last updated
02/28/2012
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