Organization
GREATER BOSTON ORAL SURGERY AND DENTAL IMPLANT CENTER PLLC
Active
Other names
Greater Boston Oral Surgery and Dental Implant Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (CREDENTIALING)
(612) 859-0444
Entity
Organization
Contact information
Practice address
101 MAIN ST STE 201, MEDFORD, MA 02155-4530
(617) 875-7827
Mailing address
101 MAIN ST STE 201, MEDFORD, MA 02155-4530
(617) 875-7827
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/18/2025
Last updated
08/18/2025
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