Organization Name: | CHILDRENS DENTAL HEALTH CENTER |
NPI Number: | 1114114360 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEVEN LEE HERSCHLAG (PRESIDENT) |
Mailing Address: | 966 Park St # C Stoughton |
State: | MA US |
Postal Code: | 020723650 |
Phone Number: | 7813410030 |
Fax Number: | 7813411166 |
NPI Enumeration Date: | 10/02/2007 |
NPI Last Update Date: | 10/02/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 16804 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |