=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295177095
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WOBURN FAMILY DENTAL INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/22/2013
-----------------------------------------------------
Last Update Date | 01/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5 CUMMINGS PARK
-----------------------------------------------------
City | WOBURN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01801-2105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-933-1765
-----------------------------------------------------
Fax | 781-933-2934
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5 CUMMINGS PARK
-----------------------------------------------------
City | WOBURN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01801-2105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-933-1765
-----------------------------------------------------
Fax | 781-933-2934
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. POOJA SAROHA
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 781-933-1765
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 21619
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------