Provider Demographics
NPI:1073925608
Name:ALICE CHENG DDS PC
Entity Type:Organization
Organization Name:ALICE CHENG DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:781-817-3645
Mailing Address - Street 1:44 ADAMS ST
Mailing Address - Street 2:UNIT #1
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-1936
Mailing Address - Country:US
Mailing Address - Phone:781-817-3645
Mailing Address - Fax:
Practice Address - Street 1:44 ADAMS ST
Practice Address - Street 2:UNIT #1
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-1936
Practice Address - Country:US
Practice Address - Phone:781-817-3645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-02
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty