Provider Demographics
NPI:1932197993
Name:SHAW, JAMES FRANKLIN (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FRANKLIN
Last Name:SHAW
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 W ASH ST
Mailing Address - Street 2:
Mailing Address - City:LA FOLLETTE
Mailing Address - State:TN
Mailing Address - Zip Code:37766-3410
Mailing Address - Country:US
Mailing Address - Phone:423-562-1064
Mailing Address - Fax:423-562-1064
Practice Address - Street 1:403 W ASH ST
Practice Address - Street 2:
Practice Address - City:LA FOLLETTE
Practice Address - State:TN
Practice Address - Zip Code:37766-3410
Practice Address - Country:US
Practice Address - Phone:423-562-1064
Practice Address - Fax:423-562-1064
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000024861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice