Organization · NPI-2

Avalon Dental LLC

Dentist, General Practice · Cambridge, MA

NPI number1700342268
StatusActive
Last updated in NPPESFeb 20, 2019

Details

NPI
1700342268
Entity type
Organization (NPI-2)
Legal business name
Avalon Dental LLC
Organization subpart
No
Enumeration date
Feb 20, 2019
Last updated
Feb 20, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice––Yes

Practice location

160 Cambridge St Unit H
Cambridge, MA 02141-1819

Phone 617-374-9500

Mailing address

160 Cambridge St Unit H
Cambridge, MA 02141-1819

Phone 617-374-9500

Authorized official

Majed Jaradeh
Owner
6177339117

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