Organization
NEDG WILMINGTON
Active
Other names
New England Dental Group, New England Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GOKULAN THIAGARAJAH (DIRECTOR/OWNER)
(508) 962-2332
Entity
Organization
Contact information
Practice address
206 BALLARDVALE ST, WILMINGTON, MA 01887-1044
(508) 962-2332
Mailing address
257 TURNPIKE RD STE 330, SOUTHBOROUGH, MA 01772-1791
(508) 281-6464
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/07/2018
Last updated
06/29/2022
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