National Provider Identifier
Mark Alan Shaw, DDS
Mark Alan Shaw, DDS is listed in the NPPES registry with a primary specialty of General Practice Dentistry in Elmira Heights, NY and a listed phone number of (607) 734-7787.
Profile Overview
- NPI
- 1831202068
- Provider Type
- Individual
- Primary Specialty
- General Practice Dentistry
- Enumeration Date
- August 15, 2006
- Last Updated
- July 08, 2007
Practice Location
- 2062 College Ave
- Elmira Heights, NY 14903-1651
Phone: (607) 734-7787
Specialties
- General Practice Dentistry (1223G0001X)
Full Record
- NPI
- 1831202068
- Entity Type
- Individual
- Last Name
- Shaw
- First Name
- Mark
- Middle Name
- Alan
- Credential
- DDS
- Mailing Street Address
- 2062 College Ave
- Mailing City
- Elmira Heights
- Mailing State
- NY
- Mailing ZIP Code
- 14903-1651
- Mailing Country
- US
- Mailing Phone
- (607) 734-7787
- Mailing Fax
- (607) 734-2496
- Practice Street Address
- 2062 College Ave
- Practice City
- Elmira Heights
- Practice State
- NY
- Practice ZIP Code
- 14903-1651
- Practice Country
- US
- Practice Phone
- (607) 734-7787
- Practice Fax
- (607) 734-2496
- Enumeration Date
- August 15, 2006
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- General Practice Dentistry (1223G0001X)
- Other Identifiers
- 02241734 (NY)