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NPI Code Detail

MEDICARE: DENTAL DREAMS LLC

MEDICARE: DENTAL DREAMS LLC
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
11223G0001XGeneral Practice Dentistry21815MA

General Provider Information

NPI Number : 1205090925
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL DREAMS LLC
Provider Business Mailing Address
First Line : 68 STAFFORD ST
Second Line :
City : WORCESTER
State : MA
Zip : 01603-1450
Country : US
Telephone Number : 508-770-0900
Fax Number : 508-770-0970
Provider Business Practice Location Address
First Line : 68 STAFFORD ST
Second Line :
City : WORCESTER
State : MA
Zip : 01603-1450
Country : US
Telephone Number : 508-770-0900
Fax Number : 508-770-0970
Authorized Official
Title or Position : OWNER / DENTIST
Name : SAMEERA HUSSAIN
Credential : DMD
Telephone Number : 312-274-9962
Provider Enumeration Date : 07/11/2008
Last Update Date : 07/11/2008

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Directions to “DENTAL DREAMS LLC ” Practice Location

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