| Roderick K Shaw Iii Dmd Pa | |
|
255 Ne Duval Ave Madison FL 32340 | |
| (850) 973-6427 | |
| (850) 973-9646 |
| Full Name | Roderick K Shaw Iii Dmd Pa |
|---|---|
| Speciality | Dentist |
| Location | 255 Ne Duval Ave, Madison, Florida |
| Authorized Official Name and Position | Kathleen B Shaw (VICE PRES) |
| Authorized Official Contact | 8509736427 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roderick K Shaw Iii Dmd Pa 255 Ne Duval Ave Madison FL 32340 Ph: (850) 973-6427 | Roderick K Shaw Iii Dmd Pa 255 Ne Duval Ave Madison FL 32340 Ph: (850) 973-6427 |
| NPI Number | 1295949444 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295949444 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN10977 (Florida) | Primary |
Madison Dental Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 189 Sw Captain Brown Rd, Madison, FL 32340 Phone: 850-973-6621 Fax: 850-973-6672 |