Healthcare Provider Details

I. General information

NPI: 1073473252
Provider Name (Legal Business Name): TRI- CITY DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

568 MAIN ST
INDIAN ORCHARD MA
01151-1207
US

IV. Provider business mailing address

568 MAIN ST
INDIAN ORCHARD MA
01151-1207
US

V. Phone/Fax

Practice location:
  • Phone: 716-939-4818
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUNIT JAIN
Title or Position: OWNER
Credential: DDS
Phone: 716-939-4818