Provider Demographics
NPI:1386242691
Name:MAULE, SHAWN (DDS)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:
Last Name:MAULE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7527 E PARADISE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-5437
Mailing Address - Country:US
Mailing Address - Phone:602-705-9168
Mailing Address - Fax:
Practice Address - Street 1:2901 S 6TH AVE
Practice Address - Street 2:
Practice Address - City:SOUTH TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-4706
Practice Address - Country:US
Practice Address - Phone:520-357-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD010881122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist