Individual
QUENTIN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
865 N ARIZOLA RD, CASA GRANDE, AZ 85222-6011
(520) 836-3446
(520) 836-8807
Mailing address
PO BOX 10097, CASA GRANDE, AZ 85230-0097
(520) 836-3446
(520) 836-8807
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4764
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4764
LICENSE
AZ
Enumeration date
07/07/2005
Last updated
08/01/2007
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