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Organization
WEST BROADWAY FAMILY DENTAL, LLC
Active
Organization
WEST BROADWAY FAMILY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARIMA RANA (MEMBER)
(646) 287-6946
Entity
Organization
Contact information
Practice address
385 WEST BROADWAY, SOUTH BOSTON, MA 02127
(617) 268-8242
Mailing address
385 WEST BROADWAY, SOUTH BOSTON, MA 02127
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1855380
MA
Other
Enumeration date
05/12/2011
Last updated
05/12/2011
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