Provider Demographics
NPI:1396415295
Name:HD GROUP LLC
Entity Type:Organization
Organization Name:HD GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVITRE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-800-7543
Mailing Address - Street 1:169 LINCOLN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-4641
Mailing Address - Country:US
Mailing Address - Phone:781-740-0100
Mailing Address - Fax:781-740-4590
Practice Address - Street 1:169 LINCOLN ST STE 101
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4641
Practice Address - Country:US
Practice Address - Phone:781-740-0100
Practice Address - Fax:781-740-4590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty