Individual
DR. ELLIOT ABRAHAM SHINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
25 S OYSTER BAY RD, SYOSSET, NY 11791-5002
(516) 365-5439
Mailing address
16 MARTIN CT, GREAT NECK, NY 11024-1620
(516) 695-0103
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
064060
NY
1223P0221X
Pediatric Dentistry
22DI02998400
NJ
1223P0221X
Pediatric Dentistry
27287
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13-3971298
EMPLOYEE IDENTIFICATION NUMBER
NY
Enumeration date
06/14/2022
Last updated
08/11/2024
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