Bridgeport Dental Arts
NPI #1265535652 in University Place, Washington
Provider Information
- NPI Number
- 1265535652
- Entity Type
- Organization
- Organization Name
- Bridgeport Dental Arts
- Primary Specialty
- Dentist
- Enumeration Date
- Sep 7, 2006
- Last Updated
- Oct 8, 2014
Practice Location
- Address
- 4103 BRIDGEPORT WAY W
- Address 2
- SUITE A
- City
- University Place
- State
- Washington
- ZIP Code
- 98466
- Phone
- (253) 565-4474
Authorized Official
- Name
- GARY R SHAW, DDS
- Title
- DENTIST OWNER
- Phone
- (253) 565-4474
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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