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General NPI Number Information
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NPI Number | 1912343211
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Entity Type | Organization
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Legal Business Name | DENTAL INNOVATORS OF MASSACHUSETTS
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Dates
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Enumeration Date | 05/14/2013
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Last Update Date | 05/14/2013
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Provider Practice Location Address
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Address Line | 24 MOHAWK PATH
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City | HOLLISTON
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State | MA
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Zip | 01746-3305
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Country | US
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Telephone | 617-435-6730
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Fax |
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Provider Business Mailing Address
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Address Line | 24 MOHAWK PATH
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City | HOLLISTON
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State | MA
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Zip | 01746-3305
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Country | US
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Telephone | 617-435-6730
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YUNG-LIEN YANG
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Credential | DMD
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Telephone | 617-435-6730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN21150
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License Number State | MA
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