| For All Ages Dental Associates | |
|
478 Torrey St Suite 1 Brockton MA 02301-4696 | |
| (508) 586-1800 | |
| Not Available |
| Full Name | For All Ages Dental Associates |
|---|---|
| Speciality | Dentist |
| Location | 478 Torrey St, Brockton, Massachusetts |
| Authorized Official Name and Position | Jenieve Paul (OWNER SOLE MBR) |
| Authorized Official Contact | 5085861800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| For All Ages Dental Associates 478 Torrey St Suite 1 Brockton MA 02301 Ph: (508) 586-1800 | For All Ages Dental Associates 478 Torrey St Suite 1 Brockton MA 02301-4696 Ph: (508) 586-1800 |
| NPI Number | 1396123642 |
|---|---|
| Provider Enumeration Date | 05/07/2015 |
| Last Update Date | 01/05/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396123642 | NPI | - | NPPES |
| 9902958 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 20981 (Massachusetts) | Primary |
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