Healthcare Provider Details

I. General information

NPI: 1457909004
Provider Name (Legal Business Name): FRIENDS & FAMILY DENTAL, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2019
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 POND ST STE 5
NATICK MA
01760-4366
US

IV. Provider business mailing address

232 POND ST STE 5
NATICK MA
01760-4366
US

V. Phone/Fax

Practice location:
  • Phone: 508-318-6333
  • Fax: 508-318-6338
Mailing address:
  • Phone: 508-318-6333
  • Fax: 508-318-6338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. BETHANY K POLNAR
Title or Position: PRESIDENT
Credential: DMD
Phone: 781-608-0307