| El Shaddai Dental | |
|
1134 N Main St Randolph MA 02368-2130 | |
| (781) 986-8800 | |
| (781) 986-1600 |
| Full Name | El Shaddai Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1134 N Main St, Randolph, Massachusetts |
| Authorized Official Name and Position | Anthony Olatunji (OWNER) |
| Authorized Official Contact | 7819868800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| El Shaddai Dental 1134 N Main St Randolph MA 02368-2130 Ph: (781) 986-8800 | El Shaddai Dental 1134 N Main St Randolph MA 02368-2130 Ph: (781) 986-8800 |
| NPI Number | 1336266980 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 07/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336266980 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 19621 (Massachusetts) | Primary |
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