| Jl Dental Associates, Llc | |
|
1892 Centre St West Roxbury MA 02132-1924 | |
| (617) 327-1350 | |
| (617) 327-1573 |
| Full Name | Jl Dental Associates, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1892 Centre St, West Roxbury, Massachusetts |
| Authorized Official Name and Position | Jonathan Jungho Lee (SOLE PROPRIETOR) |
| Authorized Official Contact | 6173271350 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jl Dental Associates, Llc 1892 Centre St West Roxbury MA 02132-1924 Ph: (617) 327-1350 | Jl Dental Associates, Llc 1892 Centre St West Roxbury MA 02132-1924 Ph: (617) 327-1350 |
| NPI Number | 1558642827 |
|---|---|
| Provider Enumeration Date | 08/31/2011 |
| Last Update Date | 08/31/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558642827 | NPI | - | NPPES |
| 110079450A | Other | MA | MASS HEALTH PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 22160 (Massachusetts) | Primary |
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