Provider Demographics
NPI:1982457834
Name:SHORE DENTAL SOLUTIONS
Entity Type:Organization
Organization Name:SHORE DENTAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:SCIORTINO-KING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-817-6709
Mailing Address - Street 1:20 SALEM RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3017
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:76 E MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2837
Practice Address - Country:US
Practice Address - Phone:516-817-6709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental