Individual
KELLY P SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
75-5995 KUAKINI HWY STE 113, KAILUA KONA, HI 96740-2120
(808) 327-0300
(808) 327-0401
Mailing address
75-5995 KUAKINI HWY STE 113, KAILUA KONA, HI 96740-2120
(808) 327-0300
(808) 327-0401
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DT1993
HI
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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