Foster Street Dental, LLC

NPI #1255639035 in Peabody, Massachusetts

Provider Information

NPI Number: 1255639035
Entity Type: Organization
Organization Name: Foster Street Dental, LLC
Primary Specialty: Dentist
Enumeration Date: Mar 3, 2011
Last Updated: Mar 3, 2011

Practice Location

Address: 80 FOSTER ST
Address 2: UNIT 104
City: Peabody
State: Massachusetts
ZIP Code: 01960-5953
Phone: (978) 944-4197

Authorized Official

Name: DR. BIPLAB KUMAR MALO, D.M.D.
Title: PRESIDENT
Phone: (978) 944-4197

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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