| NPI | 1366158727 |
|---|---|
| Doing Business As | WELLESLEY AESTHETIC DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | LEAH ANN MAYLOTT Credentialing Administrator 860-874-8198 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2023-01-27 |
| Last Update Date | 2023-01-27 |