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General NPI Number Information
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NPI Number | 1053402081
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Entity Type | Organization
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Legal Business Name | METROWEST FAMILY DENTAL
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 220 N MAIN ST SUITE 203
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City | NATICK
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State | MA
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Zip | 01760-1100
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Country | US
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Telephone | 508-655-5331
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Fax | 508-655-5449
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Provider Business Mailing Address
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Address Line | 220 N MAIN ST SUITE 203
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City | NATICK
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State | MA
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Zip | 01760-1100
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Country | US
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Telephone | 508-655-5331
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Fax | 508-655-5449
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL DAVIES
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Credential | DMD
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Telephone | 508-655-5331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 19335
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License Number State | MA
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