Healthcare Provider Details

I. General information

NPI: 1154595189
Provider Name (Legal Business Name): LORINE GAIL YEE-SHINSKY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4249 HIGHWAY 411 SUITE 3B
MADISONVILLE TN
37354-1544
US

IV. Provider business mailing address

4249 HIGHWAY 411 SUITE 3B
MADISONVILLE TN
37354-1544
US

V. Phone/Fax

Practice location:
  • Phone: 423-420-0800
  • Fax: 423-420-0877
Mailing address:
  • Phone: 423-420-0800
  • Fax: 423-420-0877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS5316
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: