| Waverley Oaks Dental Care Specialists Llc | |
|
411 Waverley Oaks Rd Bldg #3, Ste. 318 Waltham MA 02452-8448 | |
| (781) 647-0022 | |
| (781) 647-1122 |
| Full Name | Waverley Oaks Dental Care Specialists Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 411 Waverley Oaks Rd, Waltham, Massachusetts |
| Authorized Official Name and Position | Shahin Soli Sagafi (OWNER) |
| Authorized Official Contact | 7816470022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waverley Oaks Dental Care Specialists Llc 411 Waverley Oaks Rd Bldg #3, Ste. 318 Waltham MA 02452-8448 Ph: (781) 647-0022 | Waverley Oaks Dental Care Specialists Llc 411 Waverley Oaks Rd Bldg #3, Ste. 318 Waltham MA 02452-8448 Ph: (781) 647-0022 |
| NPI Number | 1336282300 |
|---|---|
| Provider Enumeration Date | 02/15/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336282300 | NPI | - | NPPES |
| X12212 | Other | MA | BLUE CROSS BLUE SHIELDS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 18464 (Massachusetts) | Primary |
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