Brockton Dental Group P.C.
Dentist, General Practice in Brockton, MA. Organization (NPI-2).
NPI number1760610026
StatusActive
Last updated in NPPESJan 16, 2015
Details
- NPI
- 1760610026
- Entity type
- Organization (NPI-2)
- Legal business name
- Brockton Dental Group P.C.
- Organization subpart
- No
- Enumeration date
- Jun 25, 2009
- Last updated
- Jan 16, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Brockton Family Dentists (Former Legal Business Name)
Practice location
231 Main StSuite #200
Brockton, MA 02301
Phone 508-588-8338 · Fax 508-583-8339
Mailing address
231 Main St.Suite #200
Brockton, MA 02301
Phone 508-588-8338 · Fax 508-583-8399
Authorized official
Ghazwan F. Ghazi
President
6174623780
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