Provider Demographics
NPI:1538477567
Name:COMFYDENTAL OF JAMAICA PLAIN, LLC
Entity Type:Organization
Organization Name:COMFYDENTAL OF JAMAICA PLAIN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZIAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ESKANDAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:832-755-2337
Mailing Address - Street 1:729 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2520
Mailing Address - Country:US
Mailing Address - Phone:617-524-1110
Mailing Address - Fax:
Practice Address - Street 1:729 CENTRE ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2520
Practice Address - Country:US
Practice Address - Phone:617-524-1110
Practice Address - Fax:617-524-1140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty