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General NPI Number Information
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NPI Number | 1902053002
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Entity Type | Organization
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Legal Business Name | ALL IN ONE DENTAL CLINIC LLC
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Dates
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Enumeration Date | 08/20/2008
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Last Update Date | 08/20/2008
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Provider Practice Location Address
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Address Line | 620 OLD WEST CENTRAL ST SUITE 201
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City | FRANKLIN
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State | MA
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Zip | 02038-2912
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Country | US
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Telephone | 508-541-7400
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Fax | 508-541-7415
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Provider Business Mailing Address
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Address Line | 620 OLD WEST CENTRAL ST SUITE 201
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City | FRANKLIN
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State | MA
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Zip | 02038-2912
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Country | US
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Telephone | 508-541-7400
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Fax | 508-541-7415
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. ANNA I ROSSIS
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Credential | DMD
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Telephone | 508-541-7400
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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 | 21716
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License Number State | MA
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