| Common Park Dental | |
|
111 Elm St Ste 203 Worcester MA 01609-1967 | |
| (617) 721-0707 | |
| Not Available |
| Full Name | Common Park Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 111 Elm St Ste 203, Worcester, Massachusetts |
| Authorized Official Name and Position | Kevin Guze (PRESIDENT) |
| Authorized Official Contact | 6177210707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Common Park Dental 15 Larchmont Ln Lexington MA 02420-4406 Ph: (617) 721-0707 | Common Park Dental 111 Elm St Ste 203 Worcester MA 01609-1967 Ph: (617) 721-0707 |
| NPI Number | 1134538416 |
|---|---|
| Provider Enumeration Date | 08/12/2014 |
| Last Update Date | 09/13/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134538416 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 21851 (Massachusetts) | Primary |
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