Provider Demographics
NPI:1144387218
Name:SHIAU, HARLAN (DDS, DMSC)
Entity Type:Individual
Prefix:DR
First Name:HARLAN
Middle Name:
Last Name:SHIAU
Suffix:
Gender:M
Credentials:DDS, DMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 STANDISH AVE
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02170-2611
Mailing Address - Country:US
Mailing Address - Phone:617-689-0404
Mailing Address - Fax:508-238-1041
Practice Address - Street 1:1140 NEWPORT AVE
Practice Address - Street 2:
Practice Address - City:SOUTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-7033
Practice Address - Country:US
Practice Address - Phone:617-689-0404
Practice Address - Fax:508-238-1041
Is Sole Proprietor?:No
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA205371223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics