| Boston Family Dental Llc | |
|
572 Pleasant St. Malden MA 02148 | |
| (781) 397-8876 | |
| (781) 324-7166 |
| Full Name | Boston Family Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 572 Pleasant St., Malden, Massachusetts |
| Authorized Official Name and Position | Ted Lee (PRACTICE MANAGER) |
| Authorized Official Contact | 7813978876 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boston Family Dental Llc 572 Pleasant St. Malden MA 02148 Ph: (781) 397-8876 | Boston Family Dental Llc 572 Pleasant St. Malden MA 02148 Ph: (781) 397-8876 |
| NPI Number | 1801962618 |
|---|---|
| Provider Enumeration Date | 11/27/2006 |
| Last Update Date | 01/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801962618 | NPI | - | NPPES |
| 611 | Other | MA | DELTA |
| 8587166 | Medicaid | MA | |
| X11902LE | Other | MA | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 16528 (Massachusetts) | Primary |
| 1223P0300X | Dentist - Periodontics | 18893 (Massachusetts) | Secondary |
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