| Salem Street Dental Pc | |
|
15 Salem St Worcester MA 01608-2006 | |
| (617) 721-0707 | |
| Not Available |
| Full Name | Salem Street Dental Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 15 Salem St, Worcester, Massachusetts |
| Authorized Official Name and Position | Kevin Guze (PRESIDENT) |
| Authorized Official Contact | 6177210707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Salem Street Dental Pc 15 Salem St Worcester MA 01608-2006 Ph: (617) 721-0707 | Salem Street Dental Pc 15 Salem St Worcester MA 01608-2006 Ph: (617) 721-0707 |
| NPI Number | 1770982985 |
|---|---|
| Provider Enumeration Date | 08/14/2014 |
| Last Update Date | 08/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770982985 | NPI | - | NPPES |
| DN21851 | Other | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN21851 (Massachusetts) | Primary |
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