MEDICARE: RB DENTAL , 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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1558831610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RB DENTAL , LLC

Provider Business Mailing Address
First Line	:	45 DODGE ST
Second Line	:
City	:	BEVERLY
State	:	MA
Zip	:	01915-1705
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 DODGE ST
Second Line	:
City	:	BEVERLY
State	:	MA
Zip	:	01915-1705
Country	:	US
Telephone Number	:	617-606-2149
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. RAHUL KHANNA
Credential	:
Telephone Number	:	978-288-1000

Provider Enumeration Date	:	12/03/2018
Last Update Date	:	04/24/2024

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Directions to “RB DENTAL , LLC ” Practice Location

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