MEDICARE: APOLLO DENTAL BRACES & IMPLANTS 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
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1265384762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APOLLO DENTAL BRACES & IMPLANTS LLC

Provider Business Mailing Address
First Line	:	4 SETTLERS RD
Second Line	:
City	:	SHREWSBURY
State	:	MA
Zip	:	01545-7721
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 E MAIN ST
Second Line	:
City	:	MARLBOROUGH
State	:	MA
Zip	:	01752-2690
Country	:	US
Telephone Number	:	339-927-5033
Fax Number	:

Authorized Official
Title or Position	:	GENERAL DENTIST
Name	:	KEERTHI C PERI
Credential	:
Telephone Number	:	339-927-5033

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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Directions to “APOLLO DENTAL BRACES & IMPLANTS LLC ” Practice Location

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