| Jerry L. Shaw, D.d.s. | |
|
1761 N. 2000 W. Farr West UT 84404-9541 | |
| (801) 731-4850 | |
| (801) 731-4852 |
| Full Name | Jerry L. Shaw, D.d.s. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1761 N. 2000 W., Farr West, Utah |
| Authorized Official Name and Position | Jerry L. Shaw (OWNER) |
| Authorized Official Contact | 8017314850 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry L. Shaw, D.d.s. 1761 N. 2000 W. Farr West UT 84404-9541 Ph: (801) 731-4850 | Jerry L. Shaw, D.d.s. 1761 N. 2000 W. Farr West UT 84404-9541 Ph: (801) 731-4850 |
| NPI Number | 1205111432 |
|---|---|
| Provider Enumeration Date | 10/19/2011 |
| Last Update Date | 10/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205111432 | NPI | - | NPPES |
| 529447754018 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 132357 (Utah) | Primary |
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Farr West Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1761 N 2000 W, Farr West, UT 84404 Phone: 801-731-4850 Fax: 801-731-4852 | |
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Farr West Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1761 N 2000 W, Farr West, UT 84404 Phone: 801-731-4850 | |
Knight Family Dentistry Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1741 N 2000 W, Farr West, UT 84404 Phone: 801-731-3200 | |
On Site Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1812 N 2000 W, Suite 8, Farr West, UT 84404 Phone: 801-731-4440 Fax: 801-731-4536 |