42 North Dental Oral Surgery of Ma, Pllc
NPI #1043979040 in Waltham, Massachusetts
Provider Information
- NPI Number
- 1043979040
- Entity Type
- Organization
- Organization Name
- 42 North Dental Oral Surgery of Ma, Pllc
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- 42 NORTH DENTAL ORAL SURGERY OF MA, PLLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Dec 17, 2021
- Last Updated
- Dec 17, 2021
Practice Location
- Address
- 200 5TH AVE FL 3
- City
- Waltham
- State
- Massachusetts
- ZIP Code
- 02451-8759
- Phone
- (781) 647-0772
Authorized Official
- Name
- DR. MICHAEL ANGELO SCIALABBA
- Title
- CHIEF CLINCAL OFFICER
- Phone
- (561) 512-2709
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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