| Beacon Dental Group | |
|
1016 Blue Hill Ave Dorchester Center MA 02124-2808 | |
| (617) 282-2146 | |
| Not Available |
| Full Name | Beacon Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1016 Blue Hill Ave, Dorchester Center, Massachusetts |
| Authorized Official Name and Position | Cressida Ladonna Joseph (OWNER) |
| Authorized Official Contact | 6172822146 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Dental Group 1016 Blue Hill Ave Dorchester Center MA 02124-2808 Ph: (617) 282-2146 | Beacon Dental Group 1016 Blue Hill Ave Dorchester Center MA 02124-2808 Ph: (617) 282-2146 |
| NPI Number | 1770756405 |
|---|---|
| Provider Enumeration Date | 04/02/2008 |
| Last Update Date | 04/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770756405 | NPI | - | NPPES |
| 9793771 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 18236 (Massachusetts) | Primary |
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