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Organization

SALEM FAMILY DENTAL AND ORTHODONTICS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NEETU BANSAL DMD (PRESIDENT)
(617) 275-6307
Entity
Organization

Contact information

Practice address
10 FEDERAL ST STE 16, SALEM, MA 01970-3875
(617) 275-6307
Mailing address
8 BRIGHTON ST APT 3, CHARLESTOWN, MA 02129-1260
(617) 275-6307

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1223P0221X
Pediatric Dentistry
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
124Q00000X
Dental Hygienist

Other

Enumeration date
05/08/2019
Last updated
05/08/2019
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