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Individual

DR. RANDOLPH S SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1080 UNION BLVD, ENGLEWOOD, OH 45322-2223
(937) 836-7592
(937) 836-6269
Mailing address
1080 UNION BLVD, ENGLEWOOD, OH 45322-2223
(937) 836-7592
(937) 836-6269

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17879
OH

Other

Enumeration date
03/28/2007
Last updated
07/08/2007
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