| Chatham Dental Health, Llc | |
|
720 Main St Chatham MA 02633-1825 | |
| (508) 945-0207 | |
| (508) 945-7541 |
| Full Name | Chatham Dental Health, Llc |
|---|---|
| Speciality | Dentist |
| Location | 720 Main St, Chatham, Massachusetts |
| Authorized Official Name and Position | Amelia Grabe Lane (SOLE MEMBER) |
| Authorized Official Contact | 5089450207 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chatham Dental Health, Llc 720 Main St Chatham MA 02633-1825 Ph: (508) 945-0207 | Chatham Dental Health, Llc 720 Main St Chatham MA 02633-1825 Ph: (508) 945-0207 |
| NPI Number | 1912141003 |
|---|---|
| Provider Enumeration Date | 04/21/2009 |
| Last Update Date | 04/21/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912141003 | NPI | - | NPPES |
| 1245441286 | Other | MA | NPI |
| 9796576 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 21491 (Massachusetts) | Primary |
Hamilton M. Sporborg, Dds, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1118 Main St, Chatham, MA 02633 Phone: 508-945-0900 Fax: 508-945-4041 |