Shaw DDS Dental Corporation
NPI #1154765899 in Los Angeles, California
Provider Information
- NPI Number
- 1154765899
- Entity Type
- Organization
- Organization Name
- Shaw DDS Dental Corporation
- Primary Specialty
- Preferred Provider Organization
- Enumeration Date
- Apr 24, 2013
- Last Updated
- Oct 25, 2013
Practice Location
- Address
- 5220 W WASHINGTON BLVD
- Address 2
- 103
- City
- Los Angeles
- State
- California
- ZIP Code
- 90016
- Phone
- (323) 933-5641
Authorized Official
- Name
- DR. ROCHELLE R SKINNER, D.D.S.
- Title
- PRESIDENT
- Phone
- (323) 933-5641
Specialties & Taxonomy Codes
| Specialty |
|---|
| Preferred Provider Organization |
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