| Unident Dental Center | |
|
200 West Gate Dr Suite 135 Brockton MA 02301 | |
| (508) 583-3840 | |
| Not Available |
| Full Name | Unident Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 200 West Gate Dr, Brockton, Massachusetts |
| Authorized Official Name and Position | Mathi Theva (PRESIDENT) |
| Authorized Official Contact | 5085833840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Unident Dental Center 200 West Gate Dr Suite 135 Brockton MA 02301 Ph: (508) 583-3840 | Unident Dental Center 200 West Gate Dr Suite 135 Brockton MA 02301 Ph: (508) 583-3840 |
| NPI Number | 1699704999 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699704999 | NPI | - | NPPES |
| 9769862 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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