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Organization
42 NORTH DENTAL CARE OF INDIANA, LLC
Active
Organization
42 NORTH DENTAL CARE OF INDIANA, LLC
Active
Parent organization
42 NORTH DENTAL CARE OF INDIANA, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
42 NORTH DENTAL CARE OF INDIANA, LLC
Authorized official
MICHAEL ANGELO SCIALABBA (CHIEF CLINICAL OFFICER)
(561) 512-2709
Entity
Organization
Contact information
Practice address
200 5TH AVE FL 3, WALTHAM, MA 02451-8759
(781) 647-0772
Mailing address
200 5TH AVE FL 3, WALTHAM, MA 02451-8759
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/19/2022
Last updated
01/19/2022
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