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NPI Code Detail

MEDICARE: ALLIANCE DENTAL

MEDICARE: ALLIANCE DENTAL
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/Center20046MA

General Provider Information

NPI Number : 1578702718
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLIANCE DENTAL
Provider Business Mailing Address
First Line : 124 COLLEGE AVE
Second Line :
City : SOMERVILLE
State : MA
Zip : 02144-1919
Country : US
Telephone Number : 617-625-0543
Fax Number : 617-666-5034
Provider Business Practice Location Address
First Line : 124 COLLEGE AVE
Second Line :
City : SOMERVILLE
State : MA
Zip : 02144-1919
Country : US
Telephone Number : 617-625-0543
Fax Number : 617-666-5034
Authorized Official
Title or Position : SOLE MBR
Name : DR. DAVID R STEUER
Credential : DMD
Telephone Number : 508-424-2526
Provider Enumeration Date : 02/11/2009
Last Update Date : 02/11/2009

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Directions to “ALLIANCE DENTAL ” Practice Location

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