Most Relevant Information
Provider Data
| NPI Number: | 1003294117 |
| Provider Name: | KYLE DREW SHAW D.D.S |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/08/2015 |
| Last Updated: | 12/11/2015 |
Provider Practice Location
114 SQUIRE HALL
BUFFALO
NY
142148006
Practice Location Phone/Fax
| Phone: | 7168293717 |
| Fax: |
Provider Mailing Location
114 SQUIRE HALL
BUFFALO
NY
142148006
Provider Mailing Phone/Fax
| Phone: | 7168293717 |
| Fax: |