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Organization

ASSEMBLY SQUARE FAMILY DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SANJEEVAN VIRK DMD (MANAGER)
(617) 764-1781
Entity
Organization

Contact information

Practice address
5 MIDDLESEX AVE, SUITE 305, 3RD FLOOR, SOMERVILLE, MA 02145-1102
(617) 764-1781
(617) 764-5649
Mailing address
5 MIDDLESEX AVE, SUITE 305, 3RD FLOOR, SOMERVILLE, MA 02145-1102
(617) 764-1781
(617) 764-5649

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1855058
MA

Other

Enumeration date
02/07/2013
Last updated
02/12/2013
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