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Organization
FOR ALL AGES DENTAL ASSOCIATES
Active
Organization
FOR ALL AGES DENTAL ASSOCIATES
Active
Other names
For all ages family dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROULA GIANNOS DMD (PRESIDENT)
(617) 905-4395
Entity
Organization
Contact information
Practice address
478 TORREY ST, BROCKTON, MA 02301-4696
(508) 586-1800
Mailing address
478 TORREY ST, BROCKTON, MA 02301-4696
(508) 586-1800
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN21173
MA
Other
Enumeration date
08/16/2013
Last updated
08/16/2013
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