Organization
MENDON FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNE TAVANO (COO)
(978) 580-1524
Entity
Organization
Contact information
Practice address
14 HASTINGS ST, MENDON, MA 01756-1079
(508) 478-8683
Mailing address
5 MOUNT ROYAL AVE STE 300, MARLBOROUGH, MA 01752-1900
(508) 460-0632
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
20209
MA
305S00000X
Point of Service
20209
MA
Other
Enumeration date
08/06/2016
Last updated
09/14/2016
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