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General NPI Number Information
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NPI Number | 1386589554
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Entity Type | Organization
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Legal Business Name | MB PEDIATRIC DENTAL GROUP PLLC
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 3 PROPRIETORS DR
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City | MARSHFIELD
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State | MA
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Zip | 02050-2192
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Country | US
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Telephone | 781-205-1124
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Fax |
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Provider Business Mailing Address
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Address Line | 88 WAREHAM ST UNIT 604
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City | BOSTON
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State | MA
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Zip | 02118-3589
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Country | US
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Telephone |
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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. MIRANDA BOYNTON
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Credential | DMD
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Telephone | 339-832-3213
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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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