Organization
BAYSHORE SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELBY MANCUSO (CEO)
(251) 213-2077
Entity
Organization
Contact information
Practice address
1701 US HIGHWAY 98, DAPHNE, AL 36526-4279
(251) 213-2077
Mailing address
PO BOX 3489, GULF SHORES, AL 36547-3489
(251) 213-2077
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/31/2024
Last updated
11/05/2024
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