Organization
LIFE BRIDGE DENTAL MA PLLC
Active
Other names
Tend Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH N SULLIVAN (DIRECTOR, RCM)
(615) 601-5250
Entity
Organization
Contact information
Practice address
12 POST OFFICE SQ, BOSTON, MA 02109-3924
(212) 686-3686
(615) 468-0325
Mailing address
DEPT CH 17135, PALATINE, IL 60055-7135
(212) 686-3686
(615) 468-0325
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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