Provider Demographics
NPI:1184199036
Name:VALUE DENTAL CENTERS OF MASSACHUSETTS, PLLC.
Entity Type:Organization
Organization Name:VALUE DENTAL CENTERS OF MASSACHUSETTS, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GENTILE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD,CAGS
Authorized Official - Phone:857-320-7804
Mailing Address - Street 1:204 ARSENAL ST APT 119
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-2787
Mailing Address - Country:US
Mailing Address - Phone:857-320-7804
Mailing Address - Fax:
Practice Address - Street 1:591 MEMORIAL DR STE 4
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-5033
Practice Address - Country:US
Practice Address - Phone:857-320-7804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-08
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty