# MADELYN SHORE, DMD, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Newport Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174121099
- **Authorized official:** DR. MADELYN GRAY SHORE DMD (OWNER)
- **Authorized official phone:** (336) 909-5777

## Contact information

- **Practice address:** 271 HOWARD BLVD, NEWPORT, NC 28570-7927
- **Practice address phone:** (252) 223-4161
- **Practice address fax:** (252) 223-2442
- **Mailing address:** PO BOX 309, NEWPORT, NC 28570-0309
- **Mailing address phone:** (252) 223-4161
- **Mailing address fax:** (252) 223-2442

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/13/2020
- **Last updated:** 10/13/2020