| Shoreline Family Dental, Llc | |
|
100 Halls Rd Ste 10-12 Old Lyme CT 06371-1456 | |
| (860) 434-7279 | |
| Not Available |
| Full Name | Shoreline Family Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 100 Halls Rd Ste 10-12, Old Lyme, Connecticut |
| Authorized Official Name and Position | Samantha Burnell (CHIEF OPERATIONS OFFICER) |
| Authorized Official Contact | 4015780274 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shoreline Family Dental, Llc 81 Danielson Pike North Scituate RI 02857-1892 Ph: () - | Shoreline Family Dental, Llc 100 Halls Rd Ste 10-12 Old Lyme CT 06371-1456 Ph: (860) 434-7279 |
| NPI Number | 1538696026 |
|---|---|
| Provider Enumeration Date | 05/16/2017 |
| Last Update Date | 05/16/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538696026 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 193400000X (* (Not Available)) | Primary |
Shoreline Dental Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Halls Rd, Old Lyme, CT 06371 Phone: 860-434-7279 | |
Old Lyme Dental Associates Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 19 Halls Rd, Suite 218, Old Lyme, CT 06371 Phone: 860-434-7378 Fax: 860-434-7537 |