Salem Street Dental Pc | |
15 Salem St Worcester MA 01608-2006 | |
(617) 721-0707 | |
Not Available |
Full Name | Salem Street Dental Pc |
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Speciality | Dentist - General Practice |
Location | 15 Salem St, Worcester, Massachusetts |
Authorized Official Name and Position | Kevin Guze (PRESIDENT) |
Authorized Official Contact | 6177210707 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Salem Street Dental Pc 15 Salem St Worcester MA 01608-2006 Ph: (617) 721-0707 | Salem Street Dental Pc 15 Salem St Worcester MA 01608-2006 Ph: (617) 721-0707 |
NPI Number | 1770982985 |
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Provider Enumeration Date | 08/14/2014 |
Last Update Date | 08/14/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770982985 | NPI | - | NPPES |
DN21851 | Other | DENTAL LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | DN21851 (Massachusetts) | Primary |
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