Organization Name: | CHILDREN'S DENTISTRY OF NORTHBOROUGH |
NPI Number: | 1396939583 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOLANTA MARIA MACDONALD (PEDIATRIC DENTIST) |
Mailing Address: | 38 Sw Cutoff Suite D Northborough |
State: | MA US |
Postal Code: | 015322159 |
Phone Number: | 5083939394 |
Fax Number: | 5083939364 |
NPI Enumeration Date: | 08/30/2007 |
NPI Last Update Date: | 11/21/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 20433 |
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. |