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General NPI Number Information
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NPI Number | 1497991095
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Entity Type | Organization
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Legal Business Name | WESTBORO DENTAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 01/02/2009
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Last Update Date | 01/02/2009
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Provider Practice Location Address
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Address Line | 33 LYMAN STREET SUITE 203A
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City | WESTBORO
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State | MA
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Zip | 01581
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Country | US
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Telephone | 508-366-0550
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Fax |
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Provider Business Mailing Address
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Address Line | 33 LYMAN ST STE 203A
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City | WESTBOROUGH
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State | MA
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Zip | 01581-1443
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Country | US
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Telephone | 508-366-0550
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD A. BALL
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Credential |
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Telephone | 508-366-0550
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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 | 14354
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License Number State | MA
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