Individual provider · Type 1 NPI
Thomas G. Shaw, DDS
Periodontics · Wauwatosa, WI
NPI number
1396865671
Active
Practice location
2600 N Mayfair Rd, Ste 340
Wauwatosa, WI 53226-1309
Fax (414) 259-0819
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Periodontics Primary | 1223P0300X | 3405 (WI) |
Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
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About NPI 1396865671
Thomas G. Shaw, DDS's National Provider Identifier is 1396865671, issued on Mar 30, 2007. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Wauwatosa, WI. The record was last updated on Jul 8, 2007.