Provider Demographics
NPI:1811480965
Name:ROYAL DENTAL BOSTON, INC
Entity type:Organization
Organization Name:ROYAL DENTAL BOSTON, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZANDPARSA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-608-3463
Mailing Address - Street 1:1051 BEACON ST STE 514
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5622
Mailing Address - Country:US
Mailing Address - Phone:617-608-3463
Mailing Address - Fax:
Practice Address - Street 1:1051 BEACON ST STE 514
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5622
Practice Address - Country:US
Practice Address - Phone:617-608-3463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental