Organization
DOVER DENTAL ASSOCIARES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAI PHAN DMD (CLERK)
(508) 785-0356
Entity
Organization
Contact information
Practice address
30 SPRINGDALE AVE., DOVER, MA 02030-0726
(508) 785-0356
(508) 785-0974
Mailing address
30 SPRINGDALE AVE., DOVER, MA 02030-0726
(508) 078-5035
(508) 785-0972
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
9140
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X11362
BLUE CROSS BLUE SHIELD
MA
Enumeration date
03/19/2008
Last updated
03/19/2008
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