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Contact Information

A SHORE DENTAL LLC
25 STAGE RD
OLD SAYBROOK, CT06475-4232
 Phone: 860-388-3845
 Fax: 203-528-4385
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for A SHORE DENTAL LLC · (Female)

NPI # 1699213025
Status Active
Credentials
Entity Individual
Enumeration date 02/06/2017
Last updated 02/06/2017 - About 9 years ago
Sole proprietor 1 Not specified
Identifiers
  • CT License # 8729
  • CT Medicaid 1223G0001X
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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