Provider Demographics
NPI:1083987374
Name:FALL RIVER DENTAL CENTER
Entity Type:Organization
Organization Name:FALL RIVER DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-567-4379
Mailing Address - Street 1:516 NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721
Mailing Address - Country:US
Mailing Address - Phone:508-567-4379
Mailing Address - Fax:508-617-8267
Practice Address - Street 1:516 NEWTON ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721
Practice Address - Country:US
Practice Address - Phone:508-567-4379
Practice Address - Fax:508-617-8267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-16
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA209091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty