Provider Demographics
NPI:1093839201
Name:NORTHBOROUGH DENTAL ASSOCIATES, P.C.
Entity type:Organization
Organization Name:NORTHBOROUGH DENTAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DENSMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-393-6160
Mailing Address - Street 1:1 E MAIN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-1662
Mailing Address - Country:US
Mailing Address - Phone:508-393-6160
Mailing Address - Fax:508-393-5526
Practice Address - Street 1:1 E MAIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1662
Practice Address - Country:US
Practice Address - Phone:508-393-6160
Practice Address - Fax:508-393-5526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty