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NPI Code Detail

MEDICARE: SMOLYAR DENTAL LLC

MEDICARE: SMOLYAR DENTAL LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1518521897
Entity Type Code : Organization
Provider Name (Legal Business Name) : SMOLYAR DENTAL LLC
Provider Business Mailing Address
First Line : 71 NEEDHAM ST
Second Line :
City : NEWTON
State : MA
Zip : 02461-1663
Country : US
Telephone Number : 617-712-2770
Fax Number :
Provider Business Practice Location Address
First Line : 71 NEEDHAM ST
Second Line :
City : NEWTON
State : MA
Zip : 02461-1663
Country : US
Telephone Number : 617-712-2770
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. ALEXANDER SMOLYAR
Credential : DMD
Telephone Number : 617-712-2770
Provider Enumeration Date : 04/23/2019
Last Update Date : 04/23/2019

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Directions to “SMOLYAR DENTAL LLC ” Practice Location

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