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General NPI Number Information
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NPI Number | 1821438144
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Entity Type | Organization
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Legal Business Name | VAS DENTAL LLC
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Dates
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Enumeration Date | 07/01/2013
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Last Update Date | 01/21/2015
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Provider Practice Location Address
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Address Line | 950 BROADWAY COMM UNIT 1
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City | CHELSEA
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State | MA
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Zip | 02150-2282
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Country | US
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Telephone | 617-889-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 534 COMMONWEALTH AVE UNIT 4A
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City | BOSTON
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State | MA
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Zip | 02215-2611
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Country | US
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Telephone | 617-501-7773
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | VANDANA SONI
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Credential | DMD
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Telephone | 617-501-7773
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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 | DN20698
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License Number State | MA
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