Aqua Dental LLC
NPI #1336392505 in Randolph, Massachusetts
Provider Information
- NPI Number
- 1336392505
- Entity Type
- Organization
- Organization Name
- Aqua Dental LLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Oct 31, 2008
- Last Updated
- Oct 31, 2008
Practice Location
- Address
- 1395 N MAIN ST
- City
- Randolph
- State
- Massachusetts
- ZIP Code
- 02368-1768
- Phone
- (781) 963-6077
Authorized Official
- Name
- JEFFREY FAYERMAN
- Title
- OWNER
- Phone
- (781) 963-6077
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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