| Idental Associates, LLC | |
|
175 Mansfield Ave Suite 9 Norton MA 02766-1333 | |
| (508) 285-4440 | |
| Not Available |
| Full Name | Idental Associates, LLC |
|---|---|
| Speciality | Dentist |
| Location | 175 Mansfield Ave, Norton, Massachusetts |
| Authorized Official Name and Position | Xiao Han (OWNER) |
| Authorized Official Contact | 5082854440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idental Associates, LLC 175 Mansfield Ave Suite 9 Norton MA 02766-1333 | Idental Associates, LLC 175 Mansfield Ave Suite 9 Norton MA 02766-1333 Ph: (508) 285-4440 |
| NPI Number | 1447421094 |
|---|---|
| Provider Enumeration Date | 03/21/2008 |
| Last Update Date | 03/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447421094 | NPI | - | NPPES |
| 0218774 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 20958 (Massachusetts) | Primary |
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