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Organization

PEDIATRIC DENTAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TODD PACHELLO (PRESIDENT CHIEF REVENUE OFFICER)
(720) 475-6482
Entity
Organization

Contact information

Practice address
1 E MAIN ST STE 104, NORTHBOROUGH, MA 01532-1662
(508) 473-5437
Mailing address
5 MOUNT ROYAL AVE, SUITE 300, MARLBOROUGH, MA 01752-1981
(508) 872-3325
(508) 872-0781

Taxonomy

Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
MA

Other

Enumeration date
10/13/2016
Last updated
01/28/2026
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