Organization
PEACHY SMILES ASHMONT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PEACH B DORE-TYRELL DMD (DENTIST)
(617) 288-2920
Entity
Organization
Contact information
Practice address
172 ASHMONT ST, DORCHESTER CENTER, MA 02124-3745
(617) 288-2920
(617) 288-2992
Mailing address
172 ASHMONT ST, DORCHESTER CENTER, MA 02124-3745
(617) 288-2920
(617) 288-2992
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19161
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0280771
MASS HEALTH
MA
Enumeration date
08/11/2008
Last updated
08/11/2008
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