Organization
SOBODENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (CREDENTIALING)
(612) 859-0444
Entity
Organization
Contact information
Practice address
590 E BROADWAY STE 1, SOUTH BOSTON, MA 02127-4479
(617) 268-1015
Mailing address
590 E BROADWAY STE 1, SOUTH BOSTON, MA 02127-4479
(617) 268-1015
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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