Sambath Keo, Dmd, Inc | |
50 Wood St Lowell MA 01851-1519 | |
(978) 441-9991 | |
(978) 441-9996 |
Full Name | Sambath Keo, Dmd, Inc |
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Speciality | Dentist - General Practice |
Location | 50 Wood St, Lowell, Massachusetts |
Authorized Official Name and Position | Sambath Keo (PRESIDENT) |
Authorized Official Contact | 9784419991 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Sambath Keo, Dmd, Inc 50 Wood St Lowell MA 01851-1519 Ph: (978) 441-9991 | Sambath Keo, Dmd, Inc 50 Wood St Lowell MA 01851-1519 Ph: (978) 441-9991 |
NPI Number | 1366614174 |
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Provider Enumeration Date | 04/01/2008 |
Last Update Date | 04/01/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366614174 | NPI | - | NPPES |
0273732 | Medicaid | MA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 17863 (Massachusetts) | Primary |
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