MARION VILLAGE DENTAL; NPI #1093128225

Contact Information

MARION VILLAGE DENTAL

54 MAIN STREET
SUITE 6 C/O LAKEVILLE DENTAL
LAKEVILLE, MA 02347

Phone: 508-923-6900
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Dental	261QD0000X

Indicates primary specialty

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NPI Profile & details for MARION VILLAGE DENTAL

NPI # 1093128225

LBN Legal business name MARION VILLAGE DENTAL

Authorized official CHUONG PHAM - (PRESIDENT/DENTIST PROVIDER)

Entity Organization

Organization subpart ¹ No

Enumeration date 06/05/2014

Last updated 06/05/2014 - About 12 years ago

Identifiers

License #

20826

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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