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General NPI Number Information
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NPI Number | 1700596103
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Entity Type | Organization
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Legal Business Name | BELMONT DENTAL GROUP, LLC.
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Dates
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Enumeration Date | 11/28/2022
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Last Update Date | 12/08/2022
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Provider Practice Location Address
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Address Line | 57 CONCORD AVE
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City | BELMONT
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State | MA
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Zip | 02478-4027
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Country | US
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Telephone | 617-484-2431
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Fax | 617-484-2745
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Provider Business Mailing Address
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Address Line | 57 CONCORD AVE
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City | BELMONT
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State | MA
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Zip | 02478-4027
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Country | US
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Telephone | 617-484-2431
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Fax |
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Authorized Official
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Title or Position | ASSISTANT OFFICE MANAGER
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Name | ERIN EAGLING
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Credential |
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Telephone | 617-484-2431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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