Full Name | 376 Dental Studio |
---|---|
Speciality | Dentist - General Practice |
Location | 376 Moody St, Waltham, Massachusetts |
Authorized Official Name and Position | Poonam Soi (OWNER/GENERAL DENTIST) |
Authorized Official Contact | 2069497622 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
376 Dental Studio 160 Cambridgepark Drive Apt 359 Cambridge MA 02140 Ph: (206) 949-7622 | 376 Dental Studio 376 Moody St Waltham MA 02453-5204 Ph: (206) 949-7622 |
NPI Number | 1174046684 |
---|---|
Provider Enumeration Date | 07/18/2017 |
Last Update Date | 07/18/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174046684 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | DN1856498 (Massachusetts) | Primary |
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