Organization
42 NORTH DENTAL ORAL SURGERY OF MA, PLLC
Active
Parent organization
42 NORTH DENTAL ORAL SURGERY OF MA, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
42 NORTH DENTAL ORAL SURGERY OF MA, PLLC
Authorized official
DR. MICHAEL ANGELO SCIALABBA (CHIEF CLINCAL 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
(781) 647-0772
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/17/2021
Last updated
12/17/2021
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