Organization · NPI-2

Central Mass Dental PLLC

Dentist · Gardner, MA

NPI number1356110472
StatusActive
Last updated in NPPESDec 29, 2023

Details

NPI
1356110472
Entity type
Organization (NPI-2)
Legal business name
Central Mass Dental PLLC
Organization subpart
No
Enumeration date
Dec 29, 2023
Certification date
Dec 29, 2023
Last updated
Dec 29, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist––Yes

Practice location

320 W Broadway
Gardner, MA 01440-3480

Phone 978-410-9664

Mailing address

201 Westford Hills Rd
Westford, MA 01886-2940

Authorized official

Yoon Hwan Edward Jeong
Dentist
9789142645

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