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Organization

PREMIER FAMILY DENTISTRY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RANI VARGHESE DMD (DENTIST)
(978) 532-7177
Entity
Organization

Contact information

Practice address
39 CROSS ST STE 101, PEABODY, MA 01960-1666
(978) 532-7177
(978) 531-9939
Mailing address
39 CROSS ST STE 101, PEABODY, MA 01960-1666

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1205199569
MA
Enumeration date
06/02/2019
Last updated
08/26/2020
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