Organization
WEBSTER SQUARE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNY LAM DMD (OWNER)
(508) 753-6777
Entity
Organization
Contact information
Practice address
17 YOUNG ST, WORCESTER, MA 01603-1420
(508) 753-6777
(508) 753-0206
Mailing address
17 YOUNG ST, WORCESTER, MA 01603-1420
(508) 753-6777
(508) 753-0206
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19810
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0202991
—
MA
05
—
0208281
—
MA
05
—
0282073
—
MA
05
—
9712470
—
MA
Enumeration date
02/02/2007
Last updated
08/22/2020
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