Organization
CHILDRENS DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BADRIEH EDALATPOUR DMD (DMD)
(781) 438-0300
Entity
Organization
Contact information
Practice address
370 MAIN STREET, #201, STONEHAM, MA 02180
(781) 438-0300
(781) 438-0336
Mailing address
370 MAIN STREET, #201, STONEHAM, MA 02180
(781) 438-0300
(781) 438-0336
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
19756
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X12536
BCBS
MA
Enumeration date
06/04/2008
Last updated
06/04/2008
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