Provider Demographics
NPI:1538491287
Name:CHELSEA FAMILY DENTAL
Entity Type:Organization
Organization Name:CHELSEA FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUSRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTIA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-887-1400
Mailing Address - Street 1:38 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-3203
Mailing Address - Country:US
Mailing Address - Phone:617-887-1400
Mailing Address - Fax:617-887-1401
Practice Address - Street 1:38 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-3203
Practice Address - Country:US
Practice Address - Phone:617-887-1400
Practice Address - Fax:617-887-1401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19968122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty