| Tufts Dental Facility Fernald | |
|
200 Trapelo Rd Waltham MA 02452-6332 | |
| (781) 899-6020 | |
| (781) 893-1829 |
| Full Name | Tufts Dental Facility Fernald |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 200 Trapelo Rd, Waltham, Massachusetts |
| Authorized Official Name and Position | John Patrick Morgan (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Contact | 7818996020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tufts Dental Facility Fernald Tufts Dental Facility Fernald 200 Trapelo Road Waltham MA 02452 Ph: (781) 899-6020 | Tufts Dental Facility Fernald 200 Trapelo Rd Waltham MA 02452-6332 Ph: (781) 899-6020 |
| NPI Number | 1871719104 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871719104 | NPI | - | NPPES |
| 0272175 | Other | MA | MASSHEALTH PROVIDER NUMBE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 20040 (Massachusetts) | Primary |
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