| Lakeside Dental Associates | |
|
50 Boston Tpke White City Shopping Center Shrewsbury MA 01545-3540 | |
| (508) 792-2991 | |
| (508) 799-7681 |
| Full Name | Lakeside Dental Associates |
|---|---|
| Speciality | Dentist |
| Location | 50 Boston Tpke, Shrewsbury, Massachusetts |
| Authorized Official Name and Position | Joseph I Mallouh (OWNER) |
| Authorized Official Contact | 5087922991 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Dental Associates 50 Boston Tpke White City Shopping Center Shrewsbury MA 01545-3540 Ph: (508) 792-2991 | Lakeside Dental Associates 50 Boston Tpke White City Shopping Center Shrewsbury MA 01545-3540 Ph: (508) 792-2991 |
| NPI Number | 1841395076 |
|---|---|
| Provider Enumeration Date | 09/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841395076 | NPI | - | NPPES |
| X12069 | Other | MA | BCBS ID # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 19877 (Massachusetts) | Primary |
Tlc Dental, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 Boston Tpke, Shrewsbury, MA 01545 Phone: 508-792-2991 | |
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