Individual
DR. MARK SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
15 GOSNELL XING, STAUNTON, VA 24401-6297
(540) 213-2244
Mailing address
15 GOSNELL XING, STAUNTON, VA 24401-6297
(540) 213-2244
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0401415192
VA
Other
Enumeration date
07/07/2014
Last updated
08/30/2016
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