Organization
CHATHAM DENTAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMELIA GRABE LANE DMD (SOLE MEMBER)
(508) 945-0207
Entity
Organization
Contact information
Practice address
720 MAIN ST, CHATHAM, MA 02633-1825
(508) 945-0207
(508) 945-7541
Mailing address
720 MAIN ST, CHATHAM, MA 02633-1825
(508) 945-0207
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
21491
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245441286
NPI
MA
05
—
9796576
—
MA
Enumeration date
04/21/2009
Last updated
04/21/2009
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