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General NPI Number Information
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NPI Number | 1689969131
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Entity Type | Organization
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Legal Business Name | DENTPLANT FRAMINGHAM LLC
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Dates
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Enumeration Date | 06/13/2011
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Last Update Date | 06/13/2011
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Provider Practice Location Address
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Address Line | 100 CONCORD ST
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City | FRAMINGHAM
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State | MA
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Zip | 01702-8328
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Country | US
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Telephone | 508-872-2624
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Fax |
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Provider Business Mailing Address
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Address Line | 23 RUSKIN ST
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City | WEST ROXBURY
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State | MA
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Zip | 02132-1811
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Country | US
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Telephone | 508-872-2624
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Fax |
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Authorized Official
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Title or Position | PERIODONTIST
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Name | DR. BRENDAN TOMAS MCLAUGHLIN
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Credential | DDS
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Telephone | 508-870-2624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN20048
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License Number State | MA
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