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Organization
MARION VILLAGE DENTAL
Active
Organization
MARION VILLAGE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHUONG PHAM DMD (PRESIDENT/DENTIST PROVIDER)
(508) 748-1700
Entity
Organization
Contact information
Practice address
54 MAIN STREET, SUITE 6 C/O LAKEVILLE DENTAL, LAKEVILLE, MA 02347
(508) 923-6900
Mailing address
156 FRONT ST STE 3, MARION, MA 02738-1501
(508) 748-1700
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
20826
MA
Other
Enumeration date
06/05/2014
Last updated
06/05/2014
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