Provider Demographics
NPI:1043305907
Name:SHAW, ARTHUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:
Last Name:SHAW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7084 ARCHIBALD AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-8716
Mailing Address - Country:US
Mailing Address - Phone:626-826-2435
Mailing Address - Fax:951-898-1350
Practice Address - Street 1:7084 ARCHIBALD AVE STE 102
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:92880-8716
Practice Address - Country:US
Practice Address - Phone:626-826-2435
Practice Address - Fax:951-898-1350
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA454661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice