Provider Demographics
NPI:1710476619
Name:CHRISTINA SHAW DMD PLLC
Entity Type:Organization
Organization Name:CHRISTINA SHAW DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-728-0234
Mailing Address - Street 1:64 BOYDEN RD STE 110
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-2570
Mailing Address - Country:US
Mailing Address - Phone:508-829-4909
Mailing Address - Fax:
Practice Address - Street 1:64 BOYDEN RD STE 110
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520-2570
Practice Address - Country:US
Practice Address - Phone:508-829-4909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental