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General NPI Number Information
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NPI Number | 1245960491
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Entity Type | Organization
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Legal Business Name | COMFORT TELEDENTISTRY
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Dates
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Enumeration Date | 06/12/2022
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 39 HOLMAN ST
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City | ATTLEBORO
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State | MA
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Zip | 02703-3033
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Country | US
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Telephone | 781-913-9858
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Fax |
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Provider Business Mailing Address
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Address Line | 3564 AVALON PARK EAST BLVD STE 1
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City | ORLANDO
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State | FL
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Zip | 32828-7365
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Country | US
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Telephone | 781-913-9858
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | JENIELL POSTELL
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Credential |
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Telephone | 781-913-9858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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