Organization
DORCHESTER PEDIATRIC DENTISTRY AND ORTHODONTICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANDANA SONI DMD (PRESIDENT)
(617) 501-7773
Entity
Organization
Contact information
Practice address
1192 BLUE HILL AVE UNIT 1192, BOSTON, MA 02126-1819
(617) 501-7773
Mailing address
8 BRIGHTON ST APT 3, CHARLESTOWN, MA 02129-1260
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN20698
MA
1223P0221X
Pediatric Dentistry
DN21051
MA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DN21679
MA
Other
Enumeration date
02/27/2018
Last updated
02/20/2020
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