Organization · Type 2 NPI
My Dental LLC
Dental Clinic/Center · Waltham, MA
NPI number
1366722100
Active
Practice location
314 Moody St, Suite B
Waltham, MA 02453-5202
Mailing address
184 Kennedy Dr, Apt 10
Malden, MA 02148-3402
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | 22184 (MA) |
Dental Clinic/Center: Definition to come...
4 other providers at this address
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About NPI 1366722100
My Dental LLC's National Provider Identifier is 1366722100, issued on Aug 24, 2011. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Waltham, MA. The record was last updated on Aug 24, 2011.