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Organization
FRESH POND DENTAL LLC
Active
Organization
FRESH POND DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREY MAZO (OWNER)
(617) 285-6414
Entity
Organization
Contact information
Practice address
180 ALEWIFE BROOK PKWY, CAMBRIDGE, MA 02138-1102
(617) 547-0700
Mailing address
180 ALEWIFE BROOK PKWY, CAMBRIDGE, MA 02138-1102
(617) 547-0700
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
18643
MA
Other
Enumeration date
11/22/2011
Last updated
11/22/2011
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