Worcester Smiles Youth Dentistry, LLC
NPI #1073661385 in Worcester, Massachusetts
Provider Information
- NPI Number
- 1073661385
- Entity Type
- Organization
- Organization Name
- Worcester Smiles Youth Dentistry, LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jan 5, 2007
- Last Updated
- Jul 9, 2014
Practice Location
- Address
- 290 PARK AVE
- City
- Worcester
- State
- Massachusetts
- ZIP Code
- 01609-1805
- Phone
- (508) 798-9040
Authorized Official
- Name
- MRS. JENELL STUMP
- Title
- MANAGER, LICENSING & CREDENTIALING
- Phone
- (615) 750-0343
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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