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General NPI Number Information
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NPI Number | 1750767240
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Entity Type | Organization
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Legal Business Name | MD CONSULTANTS
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Dates
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Enumeration Date | 08/06/2015
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Last Update Date | 08/06/2015
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Provider Practice Location Address
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Address Line | 33 BARTLETT ST #501
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City | LOWELL
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State | MA
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Zip | 01852-1334
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Country | US
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Telephone | 508-603-9554
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Fax |
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Provider Business Mailing Address
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Address Line | 31 PROSPECT ST
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City | UPTON
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State | MA
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Zip | 01568-1345
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Country | US
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Telephone | 818-825-0905
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MONA DANESHI
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Credential | DDS
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Telephone | 508-603-9554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DN1856191
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License Number State | MA
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