Individual
DR. DEWAYNE S SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4458 JONESBORO RD, FOREST PARK, GA 30297-4314
(678) 904-5665
Mailing address
4458 JONESBORO RD, FOREST PARK, GA 30297-4314
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013039
GA
Other
Enumeration date
11/29/2006
Last updated
07/09/2007
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