Provider Demographics
NPI:1073664702
Name:THOMAS DENTAL ASSOC (DBA COHASSET DENTAL)
Entity Type:Organization
Organization Name:THOMAS DENTAL ASSOC (DBA COHASSET DENTAL)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST (VICE PRESIDENT)
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:CHENETTE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-383-9393
Mailing Address - Street 1:223 CHIEF JUSTICE CUSHING HWY
Mailing Address - Street 2:SUITE #104
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-1391
Mailing Address - Country:US
Mailing Address - Phone:781-383-9393
Mailing Address - Fax:781-383-8988
Practice Address - Street 1:223 CHIEF JUSTICE CUSHING HWY
Practice Address - Street 2:SUITE #104
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-1391
Practice Address - Country:US
Practice Address - Phone:781-383-9393
Practice Address - Fax:781-383-8988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA197351223G0001X
MA165651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty