Organization
WALTHAM FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIK KAPOOR (MANAGER)
(617) 953-5221
Entity
Organization
Contact information
Practice address
30 GRANT ST, WALTHAM, MA 02453-4202
(781) 894-1634
Mailing address
30 GRANT ST, WALTHAM, MA 02453-4202
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN20802
MA
Other
Enumeration date
05/17/2016
Last updated
05/17/2016
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