MEDICARE: EDGAR E MENDOZA AND PATRICIA A SLININ DMD PC

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

General Provider Information

NPI Number	:	1922313477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDGAR E MENDOZA AND PATRICIA A SLININ DMD PC

Provider Business Mailing Address
First Line	:	70 ELM ST
Second Line	:	SUITE 1
City	:	WORCESTER
State	:	MA
Zip	:	01609-2300
Country	:	US
Telephone Number	:	508-755-1293
Fax Number	:	508-798-5256

Provider Business Practice Location Address
First Line	:	70 ELM ST
Second Line	:	SUITE 1
City	:	WORCESTER
State	:	MA
Zip	:	01609-2300
Country	:	US
Telephone Number	:	508-755-1293
Fax Number	:	508-798-5256

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EDGAR E MENDZA
Credential	:	D.M.D
Telephone Number	:	508-755-1293

Provider Enumeration Date	:	08/09/2010
Last Update Date	:	01/19/2017

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