| El Shaddai Dental Associates Mattapan Pc | |
|
542 River St Mattapan MA 02126-3014 | |
| (617) 298-1955 | |
| (617) 296-6004 |
| Full Name | El Shaddai Dental Associates Mattapan Pc |
|---|---|
| Speciality | Dentist |
| Location | 542 River St, Mattapan, Massachusetts |
| Authorized Official Name and Position | Anthony O Olatunji (OWNER) |
| Authorized Official Contact | 6172981955 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| El Shaddai Dental Associates Mattapan Pc 542 River St Mattapan MA 02126-3014 Ph: (617) 298-1955 | El Shaddai Dental Associates Mattapan Pc 542 River St Mattapan MA 02126-3014 Ph: (617) 298-1955 |
| NPI Number | 1376919696 |
|---|---|
| Provider Enumeration Date | 08/20/2015 |
| Last Update Date | 08/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376919696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN19621 (Massachusetts) | Primary |
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