Organization
ADVANCED DENTAL SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIVIANNE J KHALIFE-YAZBECK DDS (PRESIDENT)
(774) 688-9226
Entity
Organization
Contact information
Practice address
144 DARTMOUTH ST, NEW BEDFORD, MA 02740-3101
(774) 688-9226
Mailing address
140 DARTMOUTH STREET, NEW BEDFORD, MA 02740
(774) 688-9226
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21657
MA
Other
Enumeration date
07/13/2007
Last updated
07/13/2007
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