NPI 1104349182

Daniel J Shaw, DDS

Practitioner Dentist Coeur D Alene, ID

Practice location

Address: 943 W Ironwood Dr STE 200, Coeur D Alene, ID 83814-4904
Phone: (855) 433-6825
Mailing address: 6950 NE Campus Way, Hillsboro, OR 97124-5611

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence D-4867 (ID)

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Registry record

NPI: 1104349182
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Jul 2017
Record last updated: 20 Jul 2017

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.