Individual
DR. JERRY L SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1761 N 2000 W, FARR WEST, UT 84404
(801) 731-4850
(801) 731-4852
Mailing address
1761 N 2000 W, FARR WEST, UT 84404
(801) 731-4850
(801) 731-4852
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
132357
UT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
132357
UT
Other
Enumeration date
08/11/2006
Last updated
09/11/2025
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