Organization
BURLINGTON CHILDRENS DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MORTEZA YAZDI D.M.D (DENTIST)
(781) 229-2220
Entity
Organization
Contact information
Practice address
131 CAMBRIDGE ST STE 1, BURLINGTON, MA 01803-3711
(781) 229-2220
(781) 229-0258
Mailing address
30 CHESNUT AVE, SUITE 1, BURLINGTON, MA 01803-1607
(781) 229-2220
(781) 229-0258
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0297828
MASS HEALTH
MA
05
—
110011979B
—
MA
Enumeration date
05/10/2007
Last updated
06/22/2020
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