| Medford Endodontics, Llc | |
|
Zero Governors Avenue, Suite 30 Medford MA 02155-3006 | |
| (781) 391-5100 | |
| (781) 391-4833 |
| Full Name | Medford Endodontics, Llc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | Zero Governors Avenue, Suite 30, Medford, Massachusetts |
| Authorized Official Name and Position | Mark G Wang (PRESIDENT) |
| Authorized Official Contact | 7813915100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medford Endodontics, Llc Zero Governors Avenue., Suite 30 Medford MA 02155-0000 Ph: (781) 391-5100 | Medford Endodontics, Llc Zero Governors Avenue, Suite 30 Medford MA 02155-3006 Ph: (781) 391-5100 |
| NPI Number | 1780974477 |
|---|---|
| Provider Enumeration Date | 04/14/2011 |
| Last Update Date | 04/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780974477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 20514 (Massachusetts) | Primary |
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