Provider Demographics
NPI:1699149385
Name:DENTAL CENTERS,LLC
Entity type:Organization
Organization Name:DENTAL CENTERS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENDODONTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABOUSHALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-632-4411
Mailing Address - Street 1:40 NOUVELLE WAY
Mailing Address - Street 2:UNIT N349
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-1571
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:116 COCHITUATE RD
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-7989
Practice Address - Country:US
Practice Address - Phone:508-872-8806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN215801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty