Organization
APOLLO DENTAL ASS.
Active
Parent organization
APOLLO DENTAL ASS
Organization subpart
Yes
Provider details
NPI number
Legal business name
APOLLO DENTAL ASS
Authorized official
DR. DIEUTRANG BUI DMD (OWNER)
(617) 354-1678
Entity
Organization
Contact information
Practice address
940 DORCHESTER AVE, DORCHESTER, MA 02125-1218
(617) 354-1678
(617) 354-2927
Mailing address
940 DORCHESTER AVE, DORCHESTER, MA 02125-1218
(617) 354-1678
(617) 354-2927
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9703195
—
MA
Enumeration date
06/11/2012
Last updated
06/11/2012
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