Organization
CENTRAL SQUARE FAMILY DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIA FAIGEL DMD (PRESIDENT)
(617) 868-9400
Entity
Organization
Contact information
Practice address
714 MASSACHUSETTS AVE, CAMBRIDGE, MA 02139-3308
(617) 868-9400
Mailing address
714 MASSACHUSETTS AVE, CAMBRIDGE, MA 02139-3308
(617) 868-9400
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
20485
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0203980
—
MA
Enumeration date
01/16/2007
Last updated
08/22/2020
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