Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Dental |
261QD0000X |
| NPI Number | 1427538230 |
| LBN Legal business name | HAVERHILL PRIME DENTAL PLLC |
| Authorized official | ATUL BANSAL - (MANAGER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 08/21/2018 |
| Last updated | 10/29/2022 - About 4 years ago |
| Identifiers | n/a |
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