Provider Demographics
NPI:1073721114
Name:ALPHA DENTAL CENTER OF FALL RIVER, LLC
Entity Type:Organization
Organization Name:ALPHA DENTAL CENTER OF FALL RIVER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUNAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-646-9600
Mailing Address - Street 1:230 RHODE ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02724-3525
Mailing Address - Country:US
Mailing Address - Phone:508-646-9600
Mailing Address - Fax:508-646-9612
Practice Address - Street 1:230 RHODE ISLAND AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02724-3525
Practice Address - Country:US
Practice Address - Phone:508-646-9600
Practice Address - Fax:508-646-9612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA198281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty