Individual
DR. HARRY ROBERT SHAW
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
7147 SECURITY BLVD, SUITE 100 BOULEVARD PLACE, WINDSOR MILL, MD 21244-1811
(410) 298-8787
(410) 298-0146
Mailing address
7147 SECURITY BLVD, SUITE 100 BOULEVARD PLACE, WINDSOR MILL, MD 21244-1811
(410) 298-8787
(410) 298-0146
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5615
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124148
EHP, JH HEALTHCARE LLC
—
01
—
173281
UNITED CONCORDIA HONORS
—
01
—
5775
BLUE CROSS / BLUE SHIELD
MD
01
—
838342
TRICARE ACTIVE DUTY
—
01
—
95695
DENTAL BENEFIT PROVIDERS
—
01
—
MD0101612
MONTGOMERY WARD ENTERPRIS
—
Enumeration date
07/28/2005
Last updated
07/08/2007
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