Organization Name: | WESTBOROUGH DENTAL PC |
NPI Number: | 1033463856 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHELSEA PERRY (OWNER) |
Mailing Address: | 18 Lyman St Suite 105 Westborough |
State: | MA US |
Postal Code: | 015811459 |
Phone Number: | 5083668808 |
Fax Number: | 5083668808 |
NPI Enumeration Date: | 10/31/2012 |
NPI Last Update Date: | 10/31/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | DN1855146 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |