| Commonwealth Mobile Oral Health Services, Llc | |
|
12 Colleen Dr Lakeville MA 02347-1663 | |
| (508) 947-0111 | |
| (508) 743-7827 |
| Full Name | Commonwealth Mobile Oral Health Services, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12 Colleen Dr, Lakeville, Massachusetts |
| Authorized Official Name and Position | Mark J Doherty (DIRECTOR) |
| Authorized Official Contact | 5089470111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Mobile Oral Health Services, Llc 12 Colleen Dr Lakeville MA 02347-1663 Ph: (508) 947-0111 | Commonwealth Mobile Oral Health Services, Llc 12 Colleen Dr Lakeville MA 02347-1663 Ph: (508) 947-0111 |
| NPI Number | 1215081625 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 07/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215081625 | NPI | - | NPPES |
| 9756892 | Medicaid | MA | |
| 01730905 | Medicaid | NY | |
| 01761953 | Medicaid | NY | |
| 30010445 | Medicaid | NH | |
| 0245844 | Medicaid | MA | |
| 30010446 | Medicaid | NH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12683 (Massachusetts) | Primary |
Marion Village Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 54 Main Street, Suite 6 C/o Lakeville Dental, Lakeville, MA 02347 Phone: 508-923-6900 | |
Southeastern Dental Care, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 336 Bedford St, Lakeville, MA 02347 Phone: 508-947-5717 Fax: 508-947-8405 | |
Lakeville Dental Associates, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 54 Main St, Suite 6, Lakeville, MA 02347 Phone: 508-923-6900 Fax: 508-946-0306 | |
Mobile Medical Dental (ma), P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 Rhode Island Rd, Lakeville, MA 02347 Phone: 252-985-1371 | |
Southeast Orthodontics, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 40 Main St, Lakeville, MA 02347 Phone: 508-880-5891 Fax: 508-802-9050 | |
Lakeville Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 54 Main St, Suite 6, Lakeville, MA 02347 Phone: 508-923-6900 |