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General NPI Number Information
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NPI Number | 1053184739
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Entity Type | Organization
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Legal Business Name | SHORELINE DENTAL LLC
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Dates
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Enumeration Date | 11/03/2023
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Last Update Date | 11/17/2023
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Provider Practice Location Address
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Address Line | 1100 RTE 35 STE 5
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City | OCEAN
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State | NJ
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Zip | 07712-3542
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Country | US
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Telephone | 732-361-4240
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Fax |
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Provider Business Mailing Address
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Address Line | 886 CHIVAS DR
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City | TOMS RIVER
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State | NJ
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Zip | 08753-3582
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Country | US
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Telephone | 609-618-4779
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRANK CATTANESE
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Credential | DMD
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Telephone | 609-618-4779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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