| All Dental Of Revere | |
|
370 Broadway Revere MA 02151-5016 | |
| (617) 547-0700 | |
| Not Available |
| Full Name | All Dental Of Revere |
|---|---|
| Speciality | Dentist |
| Location | 370 Broadway, Revere, Massachusetts |
| Authorized Official Name and Position | Andrey Mazo (PRESIDENT) |
| Authorized Official Contact | 6172856414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| All Dental Of Revere 370 Broadway Revere MA 02151-5016 Ph: () - | All Dental Of Revere 370 Broadway Revere MA 02151-5016 Ph: (617) 547-0700 |
| NPI Number | 1285005207 |
|---|---|
| Provider Enumeration Date | 10/16/2015 |
| Last Update Date | 10/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285005207 | NPI | - | NPPES |
| 0277975 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 18643 (Massachusetts) | Primary |
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