Organization
FOR ALL AGES DENTAL ASSOCIATES
Active
Other names
For all ages family dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROULA GIANNOS DMD (PRESIDENT)
(617) 905-4395
Entity
Organization
Contact information
Practice address
478 TORREY ST, BROCKTON, MA 02301-4696
(508) 586-1800
Mailing address
478 TORREY ST, BROCKTON, MA 02301-4696
(508) 586-1800
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN21173
MA
Other
Enumeration date
08/16/2013
Last updated
08/16/2013
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