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Organization
SHINE DENTAL PC
Active
Organization
SHINE DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUSTIN SHIN DDS (PRESIDENT)
(718) 423-2248
Entity
Organization
Contact information
Practice address
4543A BELL BLVD, BAYSIDE, NY 11361-3352
(718) 423-2248
Mailing address
4543A BELL BLVD, BAYSIDE, NY 11361-3352
(718) 423-2248
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
050531
NY
Other
Enumeration date
12/18/2007
Last updated
12/18/2007
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