Provider Demographics
NPI:1821438144
Name:VAS DENTAL LLC
Entity type:Organization
Organization Name:VAS DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VANDANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SONI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-501-7773
Mailing Address - Street 1:534 COMMONWEALTH AVE
Mailing Address - Street 2:UNIT 4A
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-2611
Mailing Address - Country:US
Mailing Address - Phone:617-501-7773
Mailing Address - Fax:
Practice Address - Street 1:950 BROADWAY
Practice Address - Street 2:COMM UNIT 1
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2282
Practice Address - Country:US
Practice Address - Phone:617-889-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VAS DENTAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-01
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN206981223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty