42 North Dental Oral Surgery Of Ma, Pllc | |
200 5th Ave Fl 3 Waltham MA 02451-8759 | |
(781) 647-0772 | |
Not Available |
Full Name | 42 North Dental Oral Surgery Of Ma, Pllc |
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Speciality | Clinic/center - Dental |
Location | 200 5th Ave Fl 3, Waltham, Massachusetts |
Authorized Official Name and Position | Michael Angelo Scialabba (CHIEF CLINCAL OFFICER) |
Authorized Official Contact | 5615122709 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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42 North Dental Oral Surgery Of Ma, Pllc 200 5th Ave Fl 3 Waltham MA 02451-8759 Ph: (781) 647-0772 | 42 North Dental Oral Surgery Of Ma, Pllc 200 5th Ave Fl 3 Waltham MA 02451-8759 Ph: (781) 647-0772 |
NPI Number | 1043979040 |
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Provider Enumeration Date | 12/17/2021 |
Last Update Date | 12/17/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043979040 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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