Organization
APOLLO DENTAL ASS.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIEUTRANG BUI DMD (OWNER)
(617) 354-1678
Entity
Organization
Contact information
Practice address
413 MASS AVE, CAMBRIDGE, MA 02139-4102
(617) 354-1678
(617) 534-2927
Mailing address
413 MASS AVE, CAMBRIDGE, MA 02139-4102
(617) 354-1678
(617) 534-2927
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19385
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9703195
—
MA
Enumeration date
09/06/2007
Last updated
06/11/2012
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