Provider Demographics
NPI:1518357961
Name:VARINOS DENTAL ASSOCIATES OF WATERTOWN
Entity Type:Organization
Organization Name:VARINOS DENTAL ASSOCIATES OF WATERTOWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:T
Authorized Official - Last Name:VARINOS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-766-9402
Mailing Address - Street 1:63 MOUNT AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-3924
Mailing Address - Country:US
Mailing Address - Phone:617-923-8159
Mailing Address - Fax:617-923-2016
Practice Address - Street 1:63 MOUNT AUBURN ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-3924
Practice Address - Country:US
Practice Address - Phone:617-923-8159
Practice Address - Fax:617-923-2016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-23
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN16578122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty