Aqua Dental LLC
Clinic/Center, Dental in Randolph, Massachusetts
1336392505- Practice location
- 1395 N Main St, Randolph, MA 02368-1768
- Phone
- 781-963-6077
- Fax
- —
- Last updated
- October 31, 2008
Aqua Dental LLC is a healthcare organization based in Randolph, MA. Aqua Dental LLC practices in Randolph, MA. The NPI Number for Aqua Dental LLC is 1336392505 and holds a License No. 18450 (MA). The current practice location address for Aqua Dental LLC is 1395 N Main St, Randolph, MA 02368-1768 and can be reached out via phone at 781-963-6077.
Provider Profile Details
- NPI Number
- 1336392505
- Provider Name
- Aqua Dental LLC
- Provider Entity Type
- Organization
- Address
- 1395 N Main St, Randolph, MA 02368-1768
- Phone Number
- 781-963-6077
- Primary Taxonomy
- Clinic/Center, Dental · 261QD0000X
- Organization Subpart
- No
- Authorized Official
- Jeffrey Fayerman · Owner · 781-963-6077
- Provider Enumeration Date
- October 31, 2008
- Last Update Date
- October 31, 2008
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1395 N Main St
Randolph, MA 02368-1768 - City
- Randolph
- State
- Massachusetts
- Zip
- 02368-1768
- Phone Number
- 781-963-6077
Provider Business Mailing Address Details
- Address
- 1395 N Main St
Randolph, MA 02368-1768 - City
- Randolph
- State
- MA
- Zip
- 02368-1768
- Phone Number
- 781-963-6077
License Information
- License Number
- 18450
- 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 Aqua Dental LLC?
The NPI number of Aqua Dental LLC is 1336392505. It was assigned on October 31, 2008 and is currently active in the NPPES registry.
What is the specialty of Aqua Dental LLC?
Aqua Dental LLC is registered under the primary taxonomy Clinic/Center, Dental (code 261QD0000X), licensed in MA under license number 18450.
Where does Aqua Dental LLC practice?
The practice location is 1395 N Main St, Randolph, MA 02368-1768. The office can be reached at 781-963-6077 (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 1336392505 directly on the NPPES registry website.