Centre Street Family Dental PC
Dentist, General Practice in Jamaica Plain, MA. Organization (NPI-2).
NPI number1376705178
StatusActive
Last updated in NPPESJul 2, 2008
Details
- NPI
- 1376705178
- Entity type
- Organization (NPI-2)
- Legal business name
- Centre Street Family Dental PC
- Organization subpart
- No
- Enumeration date
- Jul 2, 2008
- Last updated
- Jul 2, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
729 Centre StJamaica Plain, MA 02130-2520
Phone 617-524-1110
Mailing address
729 Centre StJamaica Plain, MA 02130-2520
Phone 617-524-1110
Authorized official
Joseph Casey
Manager
2034157460
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