| Woburn Dental Group Pc | |
|
109 Montvale Ave Woburn MA 01801-3609 | |
| (781) 935-2345 | |
| Not Available |
| Full Name | Woburn Dental Group Pc |
|---|---|
| Speciality | Dentist |
| Location | 109 Montvale Ave, Woburn, Massachusetts |
| Authorized Official Name and Position | Xin Jenny Wang (PRESIDENT) |
| Authorized Official Contact | 7813548056 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woburn Dental Group Pc 12 Plato Ter Winchester MA 01890-2229 Ph: (781) 354-8056 | Woburn Dental Group Pc 109 Montvale Ave Woburn MA 01801-3609 Ph: (781) 935-2345 |
| NPI Number | 1598269987 |
|---|---|
| Provider Enumeration Date | 03/20/2018 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 9830572759 |
|---|---|
| Medicare Enrollment ID | O20220810000940 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598269987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN20553 (Massachusetts) | Primary |
| Provider Name | Xin Jenny Wang |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1184774044 PECOS PAC ID: 0749663664 Enrollment ID: I20220810001003 |
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