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Individual

DR. MITCHELL B. SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
510 BROADHOLLOW RD, SUITE 130, MELVILLE, NY 11747-3671
(631) 271-1522
(631) 271-1593
Mailing address
510 BROADHOLLOW RD, SUITE 130, MELVILLE, NY 11747-3671
(631) 271-1522
(631) 271-1593

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
034757
NY

Other

Enumeration date
04/05/2010
Last updated
04/05/2010
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