Healthcare Provider Details

I. General information

NPI: 1760160212
Provider Name (Legal Business Name): NATALIA CRISTINA ACOSTA-FARHADI DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NATALIA CRISTINA ACOSTA-OLIVERO DDS, MS

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 UNION ST
MARLBOROUGH MA
01752-1207
US

IV. Provider business mailing address

126 UNION ST
MARLBOROUGH MA
01752-1207
US

V. Phone/Fax

Practice location:
  • Phone: 774-374-8152
  • Fax:
Mailing address:
  • Phone: 774-374-8152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDN10001401
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: