Individual
DR. THOMAS G. SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2600 N MAYFAIR RD, STE 340, WAUWATOSA, WI 53226-1309
(414) 259-0660
(414) 259-0819
Mailing address
2600 N MAYFAIR RD, STE 340, WAUWATOSA, WI 53226-1309
(414) 259-0660
(414) 259-0819
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
3405
WI
Other
Enumeration date
03/30/2007
Last updated
07/08/2007
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