Organization
MYSTIC DENTAL STUDIO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AIDA PADRON DMD (OWNER)
(617) 884-6800
Entity
Organization
Contact information
Practice address
158 EVERETT AVE, UNIT 5, CHELSEA, MA 02150-1813
(617) 884-6800
Mailing address
158 EVERETT AVE, UNIT 5, CHELSEA, MA 02150-1813
(617) 884-6800
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
20625
MA
Other
Enumeration date
07/31/2013
Last updated
07/31/2013
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