Organization
PREMIER FAMILY DENTAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GALINA BAMFORD DMD (OWNER)
(508) 853-3394
Entity
Organization
Contact information
Practice address
610 W BOYLSTON ST, WORCESTER, MA 01606-2030
(508) 853-3394
(508) 853-6842
Mailing address
610 W BOYLSTON ST, WORCESTER, MA 01606-2030
(508) 853-3394
(508) 853-6842
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
20013
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9719008
—
MA
Enumeration date
08/31/2006
Last updated
08/22/2020
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