Provider Demographics
NPI:1538513452
Name:FRAMINGHAM FAMILY DENTAL LLC
Entity Type:Organization
Organization Name:FRAMINGHAM FAMILY DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YASER
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:WEHBE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-879-8250
Mailing Address - Street 1:130 MAYNARD RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-2504
Mailing Address - Country:US
Mailing Address - Phone:508-879-8250
Mailing Address - Fax:617-481-6635
Practice Address - Street 1:130 MAYNARD RD
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-2504
Practice Address - Country:US
Practice Address - Phone:508-879-8250
Practice Address - Fax:617-481-6635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-17
Last Update Date:2016-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20518261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental