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General NPI Number Information
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NPI Number | 1265242341
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Entity Type | Organization
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Legal Business Name | PEDIATRIC DENTAL ASSOCIATES OF NORWOOD
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 111 LENOX ST STE 113
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City | NORWOOD
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State | MA
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Zip | 02062-4278
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Country | US
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Telephone | 781-769-4473
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Fax |
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Provider Business Mailing Address
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Address Line | 9 W BROADWAY UNIT 112
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City | SOUTH BOSTON
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State | MA
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Zip | 02127-1041
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Country | US
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Telephone | 917-575-5280
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. ANDREW V DANBERG-FICARELLI
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Credential | DMD
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Telephone | 917-575-5280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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