| South Boston Family Dental Llc | |
| 
					591 E Broadway South Boston MA 02127-4404  | |
| (617) 268-5638 | |
| Not Available | 
| Full Name | South Boston Family Dental Llc | 
|---|---|
| Speciality | Dentist | 
| Location | 591 E Broadway, South Boston, Massachusetts | 
| Authorized Official Name and Position | Connie Liu (OFFICE MANAGER) | 
| Authorized Official Contact | 6175840141 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| South Boston Family Dental Llc 591 E Broadway South Boston MA 02127-4404 Ph: () -  | South Boston Family Dental Llc 591 E Broadway South Boston MA 02127-4404 Ph: (617) 268-5638  | 
| NPI Number | 1730598871 | 
|---|---|
| Provider Enumeration Date | 08/02/2014 | 
| Last Update Date | 08/02/2014 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1730598871 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 122300000X | Dentist | 18625 (Massachusetts) | Primary | 
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