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General NPI Number Information
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NPI Number | 1861500761
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE DENTAL CARE
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 786 ADAMS STREET
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City | DORCHESTER
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State | MA
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Zip | 02124-5134
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Country | US
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Telephone | 617-288-7299
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Fax | 617-474-9771
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Provider Business Mailing Address
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Address Line | 786 ADAMS STREET
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City | DORCHESTER
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State | MA
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Zip | 02124-5134
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Country | US
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Telephone | 617-288-7299
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Fax | 617-474-9771
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Authorized Official
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Title or Position | DMD/OWNER
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Name | MRS. QUE THI DINH
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Credential |
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Telephone | 617-288-7299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 19872
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 21068
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 18546
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License Number State | MA
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