Organization
NEDG - BACK BAY PLLC
Active
Other names
New England Dental Group-Back Bay
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA LACLAIR (CLINICAL SYSTEMS DIRECTOR)
(508) 281-6464
Entity
Organization
Contact information
Practice address
811 BOYLSTON ST STE 3, BOSTON, MA 02116-2679
(617) 267-3993
Mailing address
257 TURNPIKE RD STE 110, SOUTHBOROUGH, MA 01772-1791
(508) 281-6464
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/29/2022
Last updated
06/29/2022
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