| City Dental Llc | |
|
439 Broadway Everett MA 02149-3612 | |
| (617) 944-9627 | |
| (617) 944-9742 |
| Full Name | City Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 439 Broadway, Everett, Massachusetts |
| Authorized Official Name and Position | Cielito De Ayala (OFFICE MANAGER) |
| Authorized Official Contact | 4019425051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| City Dental Llc 439 Broadway Everett MA 02149-3612 Ph: (617) 944-9627 | City Dental Llc 439 Broadway Everett MA 02149-3612 Ph: (617) 944-9627 |
| NPI Number | 1467721969 |
|---|---|
| Provider Enumeration Date | 12/29/2011 |
| Last Update Date | 12/29/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467721969 | NPI | - | NPPES |
| 1548321235 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN8735 (Massachusetts) | Primary |
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