| Organization Name: | SHAW, ELY & DUBOS, D.D.S., INC. |
| NPI Number: | 1124407234 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBORAH SHAW (OFFICE MANAGER) |
| Mailing Address: | 1200 Lancaster Pike Circleville |
| State: | OH US |
| Postal Code: | 431139400 |
| Phone Number: | 7404741900 |
| Fax Number: | 7404743991 |
| NPI Enumeration Date: | 05/21/2015 |
| NPI Last Update Date: | 05/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 30.024484 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |