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Individual

DR. BEAU JOSEPH SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
36000 SHOEMAKER LANE, SUITE 1051, FORT CAVAZOS, TX 76544-5054
(254) 287-2705
Mailing address
US DENTAC HEALTH ACTIVITY FORT CAVAZOS, 36000 SHOEMAKER LANE, SUITE 1051, FORT CAVAZOS, TX 76544-5054
(254) 287-2705

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6954
OK

Other

Enumeration date
07/19/2017
Last updated
06/13/2023
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