Organization
DYNAMIC DENTAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDITA OUTERICKA (PRESIDENT)
(508) 261-9261
Entity
Organization
Contact information
Practice address
200 CHAUNCY ST, SUITE 210, MANSFIELD, MA 02048-1200
(508) 261-9261
(508) 261-9261
Mailing address
200 CHAUNCY ST, SUITE 210, MANSFIELD, MA 02048-1200
(508) 261-9261
(508) 261-9261
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
20471
MA
Other
Enumeration date
01/22/2009
Last updated
01/22/2009
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