Organization
PEDIATRIC&FAMILY DENTISTRY OF WOBURN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA BUCKLEY (OFFICE MANAGER)
(781) 933-8380
Entity
Organization
Contact information
Practice address
7 ALFRED ST, SUITE 210, WOBURN, MA 01801-1976
(781) 933-8380
Mailing address
7 ALFRED ST, SUITE 210, WOBURN, MA 01801-1976
(781) 933-8380
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9768726
—
MA
Enumeration date
03/18/2009
Last updated
03/18/2009
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