Provider Demographics
NPI:1417974106
Name:FOXBORO DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:FOXBORO DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:LEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-543-7901
Mailing Address - Street 1:132 CENTRAL STREET
Mailing Address - Street 2:UNIT #103
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035
Mailing Address - Country:US
Mailing Address - Phone:508-543-7901
Mailing Address - Fax:508-543-3147
Practice Address - Street 1:132 CENTRAL ST
Practice Address - Street 2:UNIT #103
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2433
Practice Address - Country:US
Practice Address - Phone:508-543-7901
Practice Address - Fax:508-543-3147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213171223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty