| M Moheban Dmd Pc | |
|
154 Main St Northborough MA 01532-1930 | |
| (508) 393-2522 | |
| (508) 393-9782 |
| Full Name | M Moheban Dmd Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 154 Main St, Northborough, Massachusetts |
| Authorized Official Name and Position | Mansour Moheban (PRESIDENT) |
| Authorized Official Contact | 5083932522 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| M Moheban Dmd Pc 154 Main St Northborough MA 01532-1930 Ph: (508) 393-2522 | M Moheban Dmd Pc 154 Main St Northborough MA 01532-1930 Ph: (508) 393-2522 |
| NPI Number | 1326207796 |
|---|---|
| Provider Enumeration Date | 06/02/2008 |
| Last Update Date | 06/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326207796 | NPI | - | NPPES |
| X12350 | Other | MA | BCBS MA |
| X12351 | Other | MA | BCBS MA |
| X12515 | Other | MA | BCBS MA |
| 1331231 | Other | MA | UNITED CONCORDIA |
| 262609 | Other | MA | MASS HEALTH |
| 38400 | Other | MA | HARVARD PILGRIM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 11905 (Massachusetts) | Primary |
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