Provider Demographics
NPI:1093195232
Name:UNITED DENTAL CARE CORP.
Entity Type:Organization
Organization Name:UNITED DENTAL CARE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:NAFASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-634-9393
Mailing Address - Street 1:285 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-5719
Mailing Address - Country:US
Mailing Address - Phone:617-477-7176
Mailing Address - Fax:
Practice Address - Street 1:285 MAIN ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-5719
Practice Address - Country:US
Practice Address - Phone:617-477-7176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856376305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization