Organization
COMMUNITY FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREY MAZO DMD (OWNER)
(617) 285-6414
Entity
Organization
Contact information
Practice address
648 AMERICAN LEGION HWY, ROSLINDALE, MA 02131-3901
(617) 699-9894
Mailing address
648 AMERICAN LEGION HWY, ROSLINDALE, MA 02131-3901
(617) 699-9894
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18643
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0277975
—
MA
Enumeration date
05/19/2009
Last updated
05/19/2009
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