# SHORELINE ENT PLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144354820
- **Authorized official:** NICHOLE GOODCHILD (ADMINISTRATOR)
- **Authorized official phone:** (231) 777-2625

## Contact information

- **Practice address:** 268 SEMINOLE RD, MUSKEGON, MI 49444-3733
- **Practice address phone:** (231) 777-2625
- **Practice address fax:** (231) 773-8560
- **Mailing address:** 268 SEMINOLE RD, MUSKEGON, MI 49444-3733
- **Mailing address phone:** (231) 777-2625
- **Mailing address fax:** (231) 773-8560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | NULL | Yes |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/15/2007
- **Last updated:** 07/15/2021