Individual
DANIEL ROBERT SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
25522 MARGUERITE PKWY STE 100, MISSION VIEJO, CA 92692-2920
(714) 801-4119
Mailing address
25522 MARGUERITE PKWY STE 100, MISSION VIEJO, CA 92692-2920
(714) 801-4119
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
64692
CA
Other
Enumeration date
08/12/2015
Last updated
08/12/2015
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