Provider Demographics
NPI:1962062786
Name:NEW ENGLAND TMJ ASSOCIATES
Entity type:Organization
Organization Name:NEW ENGLAND TMJ ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHUCHI
Authorized Official - Middle Name:
Authorized Official - Last Name:DHADWAL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:857-383-1140
Mailing Address - Street 1:26 NOBLE ST
Mailing Address - Street 2:
Mailing Address - City:WEST NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02465-1016
Mailing Address - Country:US
Mailing Address - Phone:857-383-1140
Mailing Address - Fax:
Practice Address - Street 1:376 MOODY ST
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-5204
Practice Address - Country:US
Practice Address - Phone:617-588-2129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-14
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty