Individual
LORI ANN SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
259 MONROE AVE, ROCHESTER, NY 14607-3632
(585) 690-2560
Mailing address
12 MALIN LN, PENFIELD, NY 14526-2233
(585) 690-2560
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
018659
NY
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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