Healthcare Provider Details

I. General information

NPI: 1225804578
Provider Name (Legal Business Name): SOAP DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7A MIDDLESEX AVE
NATICK MA
01760-4507
US

IV. Provider business mailing address

7A MIDDLESEX AVE
NATICK MA
01760-4507
US

V. Phone/Fax

Practice location:
  • Phone: 508-720-0827
  • Fax: 508-720-0828
Mailing address:
  • Phone: 508-720-0827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. BOB CHENG
Title or Position: OWNER
Credential: DMD
Phone: 646-200-1764