Healthcare Provider Details
I. General information
NPI: 1164348488
Provider Name (Legal Business Name): LEOMINSTER COMMUNITY DENTAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1079 CENTRAL ST UNIT B
LEOMINSTER MA
01453-4805
US
IV. Provider business mailing address
1079 CENTRAL ST UNIT B
LEOMINSTER MA
01453-4805
US
V. Phone/Fax
- Phone: 978-786-3343
- Fax: 978-786-3345
- Phone: 978-786-3343
- Fax: 978-786-3345
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ELIZABETH
NFOR
Title or Position: CEO
Credential: DHSC, MPH, RDH
Phone: 978-696-7726