| NPI | 1376944165 |
|---|---|
| Doing Business As | CHILDREN & FAMILY DENTISTRY OF MATTAPAN |
| Entity Type | Organization |
| Authorized Contact | JOANNE TAVANO Director 978-580-1524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MA 20209) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| 1223G0001X Dentist, General Practice | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223P0300X Dentist, Periodontics | |
| 1223P0700X Dentist, Prosthodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2019-12-04 |