| Fresh Pond Dental Llc | |
|
180 Alewife Brook Pkwy Cambridge MA 02138-1102 | |
| (617) 547-0700 | |
| Not Available |
| Full Name | Fresh Pond Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 180 Alewife Brook Pkwy, Cambridge, Massachusetts |
| Authorized Official Name and Position | Andrey Mazo (OWNER) |
| Authorized Official Contact | 6172856414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresh Pond Dental Llc 180 Alewife Brook Pkwy Cambridge MA 02138-1102 Ph: (617) 547-0700 | Fresh Pond Dental Llc 180 Alewife Brook Pkwy Cambridge MA 02138-1102 Ph: (617) 547-0700 |
| NPI Number | 1134496904 |
|---|---|
| Provider Enumeration Date | 11/22/2011 |
| Last Update Date | 11/22/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134496904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 18643 (Massachusetts) | Primary |
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