Provider Demographics
NPI:1053327601
Name:BAY SHORE SERVCIES, INC.
Entity Type:Organization
Organization Name:BAY SHORE SERVCIES, INC.
Other - Org Name:COMMUNITY DENTAL PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ATWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-341-0307
Mailing Address - Street 1:1409 WESLEY DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801
Mailing Address - Country:US
Mailing Address - Phone:410-341-0307
Mailing Address - Fax:410-341-0308
Practice Address - Street 1:531 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801
Practice Address - Country:US
Practice Address - Phone:410-912-0288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty