Healthcare Provider Details

I. General information

NPI: 1619317799
Provider Name (Legal Business Name): PAGLIA FAMILY DENTAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2013
Last Update Date: 07/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 HIGHLAND ST
MARLBOROUGH MA
01752-4127
US

IV. Provider business mailing address

154 HIGHLAND ST
MARLBOROUGH MA
01752-4127
US

V. Phone/Fax

Practice location:
  • Phone: 508-485-2235
  • Fax: 508-481-2234
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: REBECCA PAGLIA
Title or Position: PRESIDENT
Credential: DMD
Phone: 508-485-2235