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General NPI Number Information
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NPI Number | 1831513720
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Entity Type | Organization
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Legal Business Name | HAPPY KIDS DENTAL
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Dates
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Enumeration Date | 02/12/2014
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 223 WALNUT STREET SUITE #22
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City | FRAMINGHAM
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State | MA
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Zip | 01702
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Country | US
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Telephone | 508-620-5437
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Fax | 508-820-3031
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Provider Business Mailing Address
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Address Line | 223 WALNUT STREET SUITE #22
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City | FRAMINGHAM
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State | MA
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Zip | 01702
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Country | US
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Telephone | 508-620-5437
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Fax | 508-820-3031
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SATHISH L GOBICHETTYPALAYAM
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Credential | DDS
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Telephone | 617-980-4734
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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 | MA22099
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License Number State | MA
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