Great Pond Dental PC
Dentist, General Practice in Wakefield, Massachusetts
1194088096- Practice location
- 202 Lowell St, Wakefield, MA 01880-1017
- Phone
- 781-245-1731
- Fax
- 781-245-2325
- Last updated
- August 27, 2012
Great Pond Dental PC is a healthcare organization based in Wakefield, MA. Great Pond Dental PC practices in Wakefield, MA. The NPI Number for Great Pond Dental PC is 1194088096 and holds a License No. DN21849 (MA). The current practice location address for Great Pond Dental PC is 202 Lowell St, Wakefield, MA 01880-1017 and can be reached out via phone at 781-245-1731 and via fax at 781-245-2325.
Provider Profile Details
- NPI Number
- 1194088096
- Provider Name
- Great Pond Dental PC
- Provider Entity Type
- Organization
- Address
- 202 Lowell St, Wakefield, MA 01880-1017
- Phone Number
- 781-245-1731
- Fax Number
- 781-245-2325
- Primary Taxonomy
- Dentist, General Practice · 1223G0001X
- Organization Subpart
- No
- Authorized Official
- Dr. Inna O Komarovskaya, DMD · General Dentist/Owner · 781-245-1731
- Provider Enumeration Date
- June 17, 2012
- Last Update Date
- August 27, 2012
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 202 Lowell St
Wakefield, MA 01880-1017 - City
- Wakefield
- State
- Massachusetts
- Zip
- 01880-1017
- Phone Number
- 781-245-1731
- Fax Number
- 781-245-2325
Provider Business Mailing Address Details
- Address
- 202 Lowell St
Wakefield, MA 01880-1017 - City
- Wakefield
- State
- MA
- Zip
- 01880-1017
- Phone Number
- 781-245-1731
- Fax Number
- 781-245-2325
License Information
- License Number
- DN21849
- License State
- MA
- Taxonomy
- Dentist, General Practice · 1223G0001X · 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 Great Pond Dental PC?
The NPI number of Great Pond Dental PC is 1194088096. It was assigned on June 17, 2012 and is currently active in the NPPES registry.
What is the specialty of Great Pond Dental PC?
Great Pond Dental PC is registered under the primary taxonomy Dentist, General Practice (code 1223G0001X), licensed in MA under license number DN21849.
Where does Great Pond Dental PC practice?
The practice location is 202 Lowell St, Wakefield, MA 01880-1017. The office can be reached at 781-245-1731 (phone) or 781-245-2325 (fax).
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 1194088096 directly on the NPPES registry website.