| Community Family Dental | |
|
648 American Legion Hwy Roslindale MA 02131-3901 | |
| (617) 699-9894 | |
| Not Available |
| Full Name | Community Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 648 American Legion Hwy, Roslindale, Massachusetts |
| Authorized Official Name and Position | Andrey Mazo (OWNER) |
| Authorized Official Contact | 6172856414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Family Dental 648 American Legion Hwy Roslindale MA 02131-3901 Ph: (617) 699-9894 | Community Family Dental 648 American Legion Hwy Roslindale MA 02131-3901 Ph: (617) 699-9894 |
| NPI Number | 1205061207 |
|---|---|
| Provider Enumeration Date | 05/19/2009 |
| Last Update Date | 05/19/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205061207 | NPI | - | NPPES |
| 0277975 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 18643 (Massachusetts) | Primary |
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