Benjamin L Polan Dmd | |
100 Cummings Ctr S104m Beverly MA 01915-6115 | |
(978) 922-1824 | |
(978) 524-0992 |
Full Name | Benjamin L Polan Dmd |
---|---|
Speciality | Clinic/Center |
Location | 100 Cummings Ctr, Beverly, Massachusetts |
Authorized Official Name and Position | Benjmain Polan (OWNER) |
Authorized Official Contact | 9789221824 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Benjamin L Polan Dmd 100 Cummings Ctr S104m Beverly MA 01915-6115 Ph: (978) 922-1824 | Benjamin L Polan Dmd 100 Cummings Ctr S104m Beverly MA 01915-6115 Ph: (978) 922-1824 |
NPI Number | 1104375526 |
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Provider Enumeration Date | 09/27/2016 |
Last Update Date | 09/27/2016 |
Medicare PECOS PAC ID | 9739475567 |
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Medicare Enrollment ID | O20160903000019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104375526 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 14772 (Massachusetts) | Primary |
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