Organization
EPIC DENTAL SPECIALTIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN A MINER MBA (PROJECT MANAGER)
(781) 540-9043
Entity
Organization
Contact information
Practice address
315 NORWOOD PARK S, NORWOOD, MA 02062-4681
(781) 540-9043
Mailing address
315 NORWOOD PARK SOUTH, NORWOOD, MA 02062
(781) 540-9043
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DN21751
MA
1223P0221X
Pediatric Dentistry
Primary
DN20604
MA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DN11829
MA
Other
Enumeration date
04/11/2012
Last updated
04/11/2012
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