| Mount Vernon Dental Solutions | |
|
525 South Broadway Lawrence MA 01843-2837 | |
| (978) 682-0641 | |
| (978) 682-0644 |
| Full Name | Mount Vernon Dental Solutions |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 525 South Broadway, Lawrence, Massachusetts |
| Authorized Official Name and Position | Mikhail Gomer (OWNER) |
| Authorized Official Contact | 9786820641 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mount Vernon Dental Solutions 525 South Broadway Lawrence MA 01843-2837 Ph: (978) 682-0641 | Mount Vernon Dental Solutions 525 South Broadway Lawrence MA 01843-2837 Ph: (978) 682-0641 |
| NPI Number | 1639207475 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 07/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639207475 | NPI | - | NPPES |
| 9747401 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 21083 (Massachusetts) | Primary |
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