MEDICARE: FRANK Y. SHIN, DMD, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	16788	MA

General Provider Information

NPI Number	:	1184855983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRANK Y. SHIN, DMD, PC

Provider Business Mailing Address
First Line	:	1428 DORCHESTER AVE
Second Line	:
City	:	DORCHESTER
State	:	MA
Zip	:	02122-2922
Country	:	US
Telephone Number	:	617-265-5606
Fax Number	:	617-265-3803

Provider Business Practice Location Address
First Line	:	1428 DORCHESTER AVE
Second Line	:
City	:	DORCHESTER
State	:	MA
Zip	:	02122-2922
Country	:	US
Telephone Number	:	617-265-5606
Fax Number	:	617-265-3803

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. FRANK Y SHIN
Credential	:	D.M.D.
Telephone Number	:	617-265-5606

Provider Enumeration Date	:	07/28/2009
Last Update Date	:	07/28/2009

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