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Organization
SHORELINE FAMILY DENTAL, LLC
Active
Organization
SHORELINE FAMILY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SAMANTHA BURNELL (CHIEF OPERATIONS OFFICER)
(401) 578-0274
Entity
Organization
Contact information
Practice address
100 HALLS RD STE 10-12, OLD LYME, CT 06371-1456
(860) 434-7279
Mailing address
81 DANIELSON PIKE, NORTH SCITUATE, RI 02857-1892
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
193400000X
—
Other
Enumeration date
05/16/2017
Last updated
05/16/2017
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