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General NPI Number Information
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NPI Number | 1255868311
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Entity Type | Organization
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Legal Business Name | PREVENT FIRST DENTAL, L.L.C.
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Dates
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Enumeration Date | 05/18/2017
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Last Update Date | 04/13/2020
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Provider Practice Location Address
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Address Line | 32 CONCORD ST
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City | FRAMINGHAM
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State | MA
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Zip | 01702-8302
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Country | US
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Telephone | 646-703-1623
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Fax |
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Provider Business Mailing Address
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Address Line | 23 BARTLETT AVE
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City | BELMONT
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State | MA
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Zip | 02478-1802
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Country | US
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Telephone | 646-703-1623
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. MASANEL UVAYDOV
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Credential | DMD
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Telephone | 646-703-1623
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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 | DN1856882
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License Number State | MA
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