Organization · NPI-2

Gardner Family Dental Care, LLC

Dentist, General Practice · Gardner, MA

NPI number1235454893
StatusActive
Last updated in NPPESApr 7, 2010

Details

NPI
1235454893
Entity type
Organization (NPI-2)
Legal business name
Gardner Family Dental Care, LLC
Organization subpart
No
Enumeration date
Apr 7, 2010
Last updated
Apr 7, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice20133MAYes

Practice location

380 Elm St
Gardner, MA 01440-3935

Phone 978-630-1702

Mailing address

380 Elm St
Gardner, MA 01440-3935

Phone 978-630-1702

Authorized official

Suraiya M Shaikh
Manager
9786301702

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