| Webster Square Dental | |
|
17 Young St Worcester MA 01603-1420 | |
| (508) 753-6777 | |
| (508) 753-0206 |
| Full Name | Webster Square Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 17 Young St, Worcester, Massachusetts |
| Authorized Official Name and Position | Kenny Lam (OWNER) |
| Authorized Official Contact | 5087536777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Webster Square Dental 17 Young St Worcester MA 01603-1420 Ph: (508) 753-6777 | Webster Square Dental 17 Young St Worcester MA 01603-1420 Ph: (508) 753-6777 |
| NPI Number | 1629116355 |
|---|---|
| Provider Enumeration Date | 02/02/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629116355 | NPI | - | NPPES |
| 9712470 | Medicaid | MA | |
| 0202991 | Medicaid | MA | |
| 0208281 | Medicaid | MA | |
| 0282073 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 19810 (Massachusetts) | Primary |
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