Professional Dental Image Corp

NPI #1669577888 in Watertown, Massachusetts

Provider Information

NPI Number: 1669577888
Entity Type: Organization
Organization Name: Professional Dental Image Corp
Primary Specialty: Dentist
Enumeration Date: Sep 13, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 53 BIGELOW AVE
City: Watertown
State: Massachusetts
ZIP Code: 02472
Phone: (617) 924-6422

Authorized Official

Name: JUAN JOSE GRAHAM, DMD
Title: PRESIDENT
Phone: (617) 924-6422

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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