| Tataket Dental Assoc | |
| 
					6 Tataket Sq Teaticket MA 02536-5644  | |
| (508) 540-2448 | |
| (508) 548-2205 | 
| Full Name | Tataket Dental Assoc | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 6 Tataket Sq, Teaticket, Massachusetts | 
| Authorized Official Name and Position | E Leo Whitworth (PRES) | 
| Authorized Official Contact | 5085402448 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Tataket Dental Assoc 6 Tataket Sq Teaticket MA 02536-5644 Ph: (508) 540-2448  | Tataket Dental Assoc 6 Tataket Sq Teaticket MA 02536-5644 Ph: (508) 540-2448  | 
| NPI Number | 1144430505 | 
|---|---|
| Provider Enumeration Date | 05/23/2007 | 
| Last Update Date | 08/22/2020 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1144430505 | NPI | - | NPPES | 
| 9784004 | Medicaid | MA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |