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General NPI Number Information
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NPI Number | 1427538230
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Entity Type | Organization
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Legal Business Name | HAVERHILL PRIME DENTAL PLLC
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Dates
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Enumeration Date | 08/21/2018
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Last Update Date | 10/29/2022
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Provider Practice Location Address
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Address Line | 126 MAIN ST
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City | HAVERHILL
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State | MA
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Zip | 01830
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Country | US
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Telephone | 617-595-2916
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Fax |
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Provider Business Mailing Address
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Address Line | 126 MAIN ST
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City | HAVERHILL
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State | MA
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Zip | 01830-5048
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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 | MANAGER
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Name | ATUL BANSAL
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Credential |
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Telephone | 978-912-0900
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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 |
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License Number State |
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