| Whitworth Dental Assoc | |
|
542 River St Mattapan MA 02126-3014 | |
| (617) 298-1955 | |
| (617) 296-6004 |
| Full Name | Whitworth Dental Assoc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 542 River St, Mattapan, Massachusetts |
| Authorized Official Name and Position | E Leo Whitworth (PRES) |
| Authorized Official Contact | 6172981955 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Whitworth Dental Assoc 542 River St Mattapan MA 02126-3014 Ph: (617) 298-1955 | Whitworth Dental Assoc 542 River St Mattapan MA 02126-3014 Ph: (617) 298-1955 |
| NPI Number | 1578773925 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578773925 | NPI | - | NPPES |
| 9761829 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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