MEDICARE: MIDDLEBORO FAMILY DENTAL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	20518	MA
2	1223P0300X	Periodontics	14025	MA
3	122300000X	Dentist	21226	MA

General Provider Information

NPI Number	:	1083698856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDDLEBORO FAMILY DENTAL INC

Provider Business Mailing Address
First Line	:	1 ROCK ST
Second Line	:
City	:	MIDDLEBORO
State	:	MA
Zip	:	02346-2321
Country	:	US
Telephone Number	:	508-947-4411
Fax Number	:	508-947-4424

Provider Business Practice Location Address
First Line	:	1 ROCK ST
Second Line	:
City	:	MIDDLEBORO
State	:	MA
Zip	:	02346-2321
Country	:	US
Telephone Number	:	508-947-4411
Fax Number	:	508-947-4424

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. YASER JOHN WEHBE
Credential	:	D.M.D
Telephone Number	:	508-947-4411

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	09/11/2025

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