Provider Demographics
NPI:1497228498
Name:WESTWOOD DENTAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:WESTWOOD DENTAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:CROHIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-366-3804
Mailing Address - Street 1:14 SHELDON RD
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-2025
Mailing Address - Country:US
Mailing Address - Phone:781-366-3804
Mailing Address - Fax:
Practice Address - Street 1:541 HIGH ST STE 3
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-1628
Practice Address - Country:US
Practice Address - Phone:781-326-2133
Practice Address - Fax:781-320-8775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty