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General NPI Number Information
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NPI Number | 1417048117
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Entity Type | Organization
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Legal Business Name | CENTRAL DENTAL ASSOCIATES
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 47 CENTRAL ST
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City | NORWOOD
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State | MA
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Zip | 02062
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Country | US
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Telephone | 781-769-3566
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Fax | 781-769-0992
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Provider Business Mailing Address
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Address Line | 47 CENTRAL ST
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City | NORWOOD
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State | MA
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Zip | 02062
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Country | US
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Telephone | 781-769-3566
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Fax | 781-769-0992
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT L VIVENTI
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Credential | DMD
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Telephone | 781-769-3566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 15645
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 18350
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 17964
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 17718
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License Number State | MA
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