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General NPI Number Information
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NPI Number | 1831877851
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Entity Type | Organization
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Legal Business Name | SUDBURY DENTAL ASSOCIATES
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Dates
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Enumeration Date | 07/10/2023
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 410 BOSTON POST RD
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City | SUDBURY
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State | MA
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Zip | 01776-3058
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Country | US
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Telephone | 617-686-8254
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Fax |
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Provider Business Mailing Address
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Address Line | 25 TRUMAN RD
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City | NEWTON CENTER
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State | MA
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Zip | 02459-2638
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Country | US
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Telephone |
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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. YALI LOU
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Credential |
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Telephone | 617-686-8254
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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 |
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License Number State |
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