Organization
SURPRISE MODERN DENTISTRY LLP
Active
Other names
Surprise Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA J SHAW DMD (OWNER)
(623) 777-3329
Entity
Organization
Contact information
Practice address
13733 N PRASADA PKWY STE 108, SURPRISE, AZ 85388-8007
(623) 777-3329
(623) 900-2676
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8892
(303) 952-0892
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/26/2021
Last updated
11/26/2021
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