Randolph Dental Smile PLLC
Dentist, General Practice in Randolph, MA. Organization (NPI-2).
NPI number1982178281
StatusActive
Last updated in NPPESJan 20, 2019
Details
- NPI
- 1982178281
- Entity type
- Organization (NPI-2)
- Legal business name
- Randolph Dental Smile PLLC
- Organization subpart
- No
- Enumeration date
- Jan 20, 2019
- Last updated
- Jan 20, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
89 S Main StRandolph, MA 02368-4896
Phone 781-963-4343
Mailing address
3 Jamie LnShrewsbury, MA 01545-6319
Phone 781-526-5042
Authorized official
Ammar Bash
Dentist/Owner
7815265042
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