| Great Pond Dental Pc | |
|
202 Lowell St Wakefield MA 01880-1017 | |
| (781) 245-1731 | |
| (781) 245-2325 |
| Full Name | Great Pond Dental Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 202 Lowell St, Wakefield, Massachusetts |
| Authorized Official Name and Position | Inna O Komarovskaya (GENERAL DENTIST/OWNER) |
| Authorized Official Contact | 7812451731 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Pond Dental Pc 202 Lowell St Wakefield MA 01880-1017 Ph: (781) 245-1731 | Great Pond Dental Pc 202 Lowell St Wakefield MA 01880-1017 Ph: (781) 245-1731 |
| NPI Number | 1194088096 |
|---|---|
| Provider Enumeration Date | 06/17/2012 |
| Last Update Date | 08/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194088096 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN21849 (Massachusetts) | Primary |
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