Fresh Pond Dental LLC
Clinic/Center, Dental in Cambridge, Massachusetts
1134496904- Practice location
- 180 Alewife Brook Pkwy, Cambridge, MA 02138-1102
- Phone
- 617-547-0700
- Fax
- —
- Last updated
- November 22, 2011
Fresh Pond Dental LLC is a healthcare organization based in Cambridge, MA. Fresh Pond Dental LLC practices in Cambridge, MA. The NPI Number for Fresh Pond Dental LLC is 1134496904 and holds a License No. 18643 (MA). The current practice location address for Fresh Pond Dental LLC is 180 Alewife Brook Pkwy, Cambridge, MA 02138-1102 and can be reached out via phone at 617-547-0700.
Provider Profile Details
- NPI Number
- 1134496904
- Provider Name
- Fresh Pond Dental LLC
- Provider Entity Type
- Organization
- Address
- 180 Alewife Brook Pkwy, Cambridge, MA 02138-1102
- Phone Number
- 617-547-0700
- Primary Taxonomy
- Clinic/Center, Dental · 261QD0000X
- Organization Subpart
- No
- Authorized Official
- Dr. Andrey Mazo · Owner · 617-285-6414
- Provider Enumeration Date
- November 22, 2011
- Last Update Date
- November 22, 2011
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 180 Alewife Brook Pkwy
Cambridge, MA 02138-1102 - City
- Cambridge
- State
- Massachusetts
- Zip
- 02138-1102
- Phone Number
- 617-547-0700
Provider Business Mailing Address Details
- Address
- 180 Alewife Brook Pkwy
Cambridge, MA 02138-1102 - City
- Cambridge
- State
- MA
- Zip
- 02138-1102
- Phone Number
- 617-547-0700
License Information
- License Number
- 18643
- License State
- MA
- Taxonomy
- Clinic/Center, Dental · 261QD0000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Fresh Pond Dental LLC?
The NPI number of Fresh Pond Dental LLC is 1134496904. It was assigned on November 22, 2011 and is currently active in the NPPES registry.
What is the specialty of Fresh Pond Dental LLC?
Fresh Pond Dental LLC is registered under the primary taxonomy Clinic/Center, Dental (code 261QD0000X), licensed in MA under license number 18643.
Where does Fresh Pond Dental LLC practice?
The practice location is 180 Alewife Brook Pkwy, Cambridge, MA 02138-1102. The office can be reached at 617-547-0700 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1134496904 directly on the NPPES registry website.