| Tashkent Dental Inc | |
|
60 Lewis St Suite 6 Lynn MA 01902-4858 | |
| (866) 942-5444 | |
| (866) 942-5444 |
| Full Name | Tashkent Dental Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 60 Lewis St, Lynn, Massachusetts |
| Authorized Official Name and Position | Ilyoss Gulyamov (DENTIST, PRESIDENT) |
| Authorized Official Contact | 8669425444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tashkent Dental Inc 60 Lewis St Suite 6 Lynn MA 01902-4858 Ph: (866) 942-5444 | Tashkent Dental Inc 60 Lewis St Suite 6 Lynn MA 01902-4858 Ph: (866) 942-5444 |
| NPI Number | 1336527696 |
|---|---|
| Provider Enumeration Date | 05/07/2015 |
| Last Update Date | 05/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336527696 | NPI | - | NPPES |
| 110097277A | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN1856045 (Massachusetts) | Primary |
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