| Medford Tlc Dental Group, Llc | |
|
84 High St Ste 5 Medford MA 02155-3844 | |
| (781) 393-0008 | |
| Not Available |
| Full Name | Medford Tlc Dental Group, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 84 High St Ste 5, Medford, Massachusetts |
| Authorized Official Name and Position | Anna Ganopolsky (OWNER) |
| Authorized Official Contact | 7813930008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medford Tlc Dental Group, Llc 84 High St Ste 5 Medford MA 02155-3844 Ph: (781) 393-0008 | Medford Tlc Dental Group, Llc 84 High St Ste 5 Medford MA 02155-3844 Ph: (781) 393-0008 |
| NPI Number | 1457863953 |
|---|---|
| Provider Enumeration Date | 10/25/2017 |
| Last Update Date | 10/26/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457863953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN19618 (Massachusetts) | Primary |
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