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General NPI Number Information
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NPI Number | 1134399728
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Entity Type | Organization
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Legal Business Name | CLARA PATRICIA VARGAS D.M.D. LLC
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Dates
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Enumeration Date | 03/10/2008
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Last Update Date | 03/10/2008
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Provider Practice Location Address
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Address Line | 263 WASHINGTON ST
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City | DEDHAM
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State | MA
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Zip | 02026-1826
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Country | US
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Telephone | 781-251-0550
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Fax |
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Provider Business Mailing Address
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Address Line | 263 WASHINGTON ST
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City | DEDHAM
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State | MA
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Zip | 02026-1826
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Country | US
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Telephone | 781-251-0550
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Fax |
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | CLARA PATRICIA VARGAS
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Credential | D.M.D.
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Telephone | 781-251-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 19119
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License Number State | MA
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