Distinctive Dental Associates

NPI #1114136504 in Worcester, Massachusetts

Provider Information

NPI Number: 1114136504
Entity Type: Organization
Organization Name: Distinctive Dental Associates
Primary Specialty: Dentist
Enumeration Date: May 22, 2007
Last Updated: Jun 18, 2008

Practice Location

Address: 255 PARK AVE
Address 2: SUITE 904
City: Worcester
State: Massachusetts
ZIP Code: 01609-1953
Phone: (508) 792-9010

Authorized Official

Name: DR. STEPHEN WAXMAN, D.M.D.
Title: DENTIST
Phone: (508) 792-9010

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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