Provider Demographics
NPI:1770860801
Name:SHAW, ARTHUR DONALD (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:DONALD
Last Name:SHAW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:A
Other - Middle Name:DON
Other - Last Name:SHAW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3875 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-2219
Mailing Address - Country:US
Mailing Address - Phone:409-833-0760
Mailing Address - Fax:409-833-2327
Practice Address - Street 1:3875 LAUREL ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-2219
Practice Address - Country:US
Practice Address - Phone:409-833-0760
Practice Address - Fax:409-833-2327
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX191841223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice