# SHORES DENTAL PLLC

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

## Provider details

- **NPI number:** 1720528599
- **Authorized official:** DR. RANDALL SHAW DDS, MS (MANAGER)
- **Authorized official phone:** (248) 931-1151

## Contact information

- **Practice address:** 28503 LITTLE MACK AVE, SAINT CLAIR SHORES, MI 48081-1119
- **Practice address phone:** (248) 771-1990
- **Mailing address:** 350 PINE RIDGE DR, BLOOMFIELD HILLS, MI 48304-2139
- **Mailing address phone:** (248) 931-1151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 13819 | MI | Yes |

## Other

- **Enumeration date:** 02/27/2017
- **Last updated:** 02/27/2017