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General NPI Number Information
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NPI Number | 1679376230
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Entity Type | Organization
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Legal Business Name | PERLA PEDIATRIC SMILES
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Dates
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Enumeration Date | 03/29/2025
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Last Update Date | 03/29/2025
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Provider Practice Location Address
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Address Line | 70 HASTINGS ST STE 103
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City | WELLESLEY
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State | MA
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Zip | 02481-5439
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Country | US
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Telephone | 617-420-1616
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Fax | 617-912-5603
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Provider Business Mailing Address
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Address Line | 200 ESTATE DR APT 202
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City | CHESTNUT HILL
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State | MA
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Zip | 02467-3538
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Country | US
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Telephone | 857-707-7207
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Fax | 617-912-5603
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NILOUFAR MOAZINIYA
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Credential | DDS
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Telephone | 857-707-7207
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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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