Organization
MEDFORD TLC DENTAL GROUP, LLC
Active
Other names
TLC Dental of Medford
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNA GANOPOLSKY DMD (OWNER)
(781) 393-0008
Entity
Organization
Contact information
Practice address
84 HIGH ST STE 5, MEDFORD, MA 02155-3844
(781) 393-0008
Mailing address
84 HIGH ST STE 5, MEDFORD, MA 02155-3844
(781) 393-0008
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN19618
MA
Other
Enumeration date
10/25/2017
Last updated
10/26/2017
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