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42 North Dental Care, LLC

Clinic/Center, Dental in Boston, MA. Organization (NPI-2).

NPI number1750650412
StatusActive
Last updated in NPPESJun 21, 2021

Details

NPI
1750650412
Entity type
Organization (NPI-2)
Legal business name
42 North Dental Care, LLC
Organization subpart
Yes
Enumeration date
Dec 23, 2011
Certification date
Jun 21, 2021
Last updated
Jun 21, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QD0000X Clinic/Center, Dental––Yes

Other names

  • Gentle Dental Tremont (Doing Business As)

Practice location

131 Tremont St
Boston, MA 02111-1317

Phone 617-292-0500

Mailing address

200 5th Ave Fl 3
Waltham, MA 02451-8759

Phone 781-647-0772

Authorized official

Michael Angelo Scialabba
Chief Clinical Officer
5615122709

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