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Organization
BELMONT PROSTHODONTICS
Active
Organization
BELMONT PROSTHODONTICS
Active
Other names
Dental Restorative Group @ Belmont
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN CHANG DMD (OWNER)
(617) 489-1470
Entity
Organization
Contact information
Practice address
385 CONCORD AVE STE 100, BELMONT, MA 02478-3037
(617) 489-1470
(617) 489-4908
Mailing address
385 CONCORD AVE STE 100, BELMONT, MA 02478-3037
(617) 489-1470
(617) 489-4908
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
MA
1223P0300X
Periodontics
—
MA
1223P0700X
Prosthodontics
Primary
—
MA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821151853
NPI
MA
Enumeration date
02/25/2016
Last updated
02/25/2016
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