| 42 North Dental Care Of Indiana, Llc | |
|
200 5th Ave Fl 3 Waltham MA 02451-8759 | |
| (781) 647-0772 | |
| Not Available |
| Full Name | 42 North Dental Care Of Indiana, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 200 5th Ave Fl 3, Waltham, Massachusetts |
| Authorized Official Name and Position | Michael Angelo Scialabba (CHIEF CLINICAL OFFICER) |
| Authorized Official Contact | 5615122709 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 42 North Dental Care Of Indiana, Llc 200 5th Ave Fl 3 Waltham MA 02451-8759 Ph: () - | 42 North Dental Care Of Indiana, Llc 200 5th Ave Fl 3 Waltham MA 02451-8759 Ph: (781) 647-0772 |
| NPI Number | 1679225965 |
|---|---|
| Provider Enumeration Date | 01/19/2022 |
| Last Update Date | 01/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679225965 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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