Individual
ALICE LOUISE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1714 W HUNT HWY STE 100, QUEEN CREEK, AZ 85143-5245
(480) 882-3119
Mailing address
2827 W NORTHVIEW AVE, PHOENIX, AZ 85051-7586
(602) 377-7754
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D010382
AZ
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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