Provider Demographics
NPI:1740057538
Name:SHORELINE DENTAL PLLC
Entity type:Organization
Organization Name:SHORELINE DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-353-2152
Mailing Address - Street 1:6 STONEY BEACH RD
Mailing Address - Street 2:
Mailing Address - City:HULL
Mailing Address - State:MA
Mailing Address - Zip Code:02045-3317
Mailing Address - Country:US
Mailing Address - Phone:407-353-2152
Mailing Address - Fax:
Practice Address - Street 1:20 EAST ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-1638
Practice Address - Country:US
Practice Address - Phone:781-826-2826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice