| Shines Llc | |
|
11085 Resort Rd Ste 400 Ellicott City MD 21042-2071 | |
| (312) 505-1629 | |
| Not Available |
| Full Name | Shines Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 11085 Resort Rd Ste 400, Ellicott City, Maryland |
| Authorized Official Name and Position | Eui Shin (OWNER) |
| Authorized Official Contact | 3125051629 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shines Llc 11085 Resort Rd Ste 400 Ellicott City MD 21042-2071 Ph: (312) 505-1629 | Shines Llc 11085 Resort Rd Ste 400 Ellicott City MD 21042-2071 Ph: (312) 505-1629 |
| NPI Number | 1649928649 |
|---|---|
| Provider Enumeration Date | 03/17/2022 |
| Last Update Date | 03/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649928649 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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