Provider Demographics
NPI:1316800493
Name:NORTHSHORE FAMILY DENTAL PLLC
Entity type:Organization
Organization Name:NORTHSHORE FAMILY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PARSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:231-215-3890
Mailing Address - Street 1:1037 N BUYS RD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49445-1809
Mailing Address - Country:US
Mailing Address - Phone:231-215-3890
Mailing Address - Fax:
Practice Address - Street 1:1179 WHITEHALL RD STE A
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49445-2497
Practice Address - Country:US
Practice Address - Phone:231-744-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-05
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty