Organization
BEACON DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRESSIDA LADONNA JOSEPH DMD (OWNER)
(617) 282-2146
Entity
Organization
Contact information
Practice address
1016 BLUE HILL AVE, DORCHESTER CENTER, MA 02124-2808
(617) 282-2146
Mailing address
1016 BLUE HILL AVE, DORCHESTER CENTER, MA 02124-2808
(617) 282-2146
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18236
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9793771
—
MA
Enumeration date
04/02/2008
Last updated
04/02/2008
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