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General NPI Number Information
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NPI Number | 1871466946
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Entity Type | Organization
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Legal Business Name | NORTH DENTAL OF MASSACHUSETTS, PLLC
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 270 QUINCY AVE STE A
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City | QUINCY
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State | MA
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Zip | 02169-8127
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Country | US
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Telephone | 617-773-9500
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Fax |
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Provider Business Mailing Address
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Address Line | 270 QUINCY AVE STE A
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City | QUINCY
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State | MA
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Zip | 02169-8127
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Country | US
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Telephone | 617-773-9500
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Fax |
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Authorized Official
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Title or Position | CHIEF CLINICAL OFFICER
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Name | MICHAEL ANGELO SCIALABBA
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Credential |
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Telephone | 561-512-2709
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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