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General NPI Number Information
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NPI Number | 1699876318
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Entity Type | Organization
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Legal Business Name | BCH DENTAL GROUP
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 12/07/2017
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Provider Practice Location Address
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Address Line | 300 LONGWOOD AVE PATIENT FINANCIAL SERVICES ATN STEVEN NICOLL
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City | BOSTON
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State | MA
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Zip | 02115-5724
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Country | US
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Telephone | 617-355-4831
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Fax | 617-730-0080
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Provider Business Mailing Address
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Address Line | 300 LONGWOOD AVE
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City | BOSTON
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State | MA
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Zip | 02115-5724
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Country | US
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Telephone | 617-355-6000
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Fax |
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Authorized Official
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Title or Position | DEPARTMENT CHIEF
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Name | DR. MAN WAI NG
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Credential | DDS
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Telephone | 617-355-6000
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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 | MA
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