Organization
BRIGHTON DENTAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NOPSARAN CHAIMATTAYOMPOL DMD (DIRECTOR)
(617) 782-5455
Entity
Organization
Contact information
Practice address
1607 COMMONWEALTH AVE, SUITE #3, BRIGHTON, MA 02135-4214
(617) 782-5455
(617) 782-5452
Mailing address
1607 COMMONWEALTH AVE, SUITE #3, BRIGHTON, MA 02135-4214
(617) 782-5455
(617) 782-5452
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
20789
MA
Other
Enumeration date
12/22/2008
Last updated
12/22/2008
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