NPI 1033729991

Brock Shaw, DDS

Practitioner Dentist Apo, AP

Practice location

Address: 18 Mdg Unit 5142, Apo, AP 96368-5142
Phone: (315) 630-4902

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 11826346 (UT)

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Registry record

NPI: 1033729991
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Aug 2020
Record last updated: 10 Oct 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.