Provider Demographics
NPI:1275761363
Name:DENTAL ASSOCIATES OF MARLBOROUGH, DR. NEHRA LLC
Entity Type:Organization
Organization Name:DENTAL ASSOCIATES OF MARLBOROUGH, DR. NEHRA LLC
Other - Org Name:DENTAL ASSOCIATES OF MARLBOROUGH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:SANJIV
Authorized Official - Middle Name:
Authorized Official - Last Name:NEHRA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-309-4040
Mailing Address - Street 1:222 BOLTON ST
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-3902
Mailing Address - Country:US
Mailing Address - Phone:508-485-1800
Mailing Address - Fax:
Practice Address - Street 1:222 BOLTON ST
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3902
Practice Address - Country:US
Practice Address - Phone:508-485-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-26
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental