| Beverly Dental Group LLC | |
|
16 Enon St Beverly MA 01915-1116 | |
| (617) 921-6292 | |
| Not Available |
| Full Name | Beverly Dental Group LLC |
|---|---|
| Speciality | Dentist |
| Location | 16 Enon St, Beverly, Massachusetts |
| Authorized Official Name and Position | Richard Miller (PRESIDENT) |
| Authorized Official Contact | 6179216292 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beverly Dental Group LLC 16 Enon St Beverly MA 01915-1116 Ph: (617) 921-6292 | Beverly Dental Group LLC 16 Enon St Beverly MA 01915-1116 Ph: (617) 921-6292 |
| NPI Number | 1144678012 |
|---|---|
| Provider Enumeration Date | 06/01/2016 |
| Last Update Date | 06/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144678012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 20980 (Massachusetts) | Primary |
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