Provider Demographics
NPI:1598526287
Name:ATLAS DENTAL PLLC
Entity Type:Organization
Organization Name:ATLAS DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GINZBURG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-935-7229
Mailing Address - Street 1:2001 BEACON ST STE 102
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-7788
Mailing Address - Country:US
Mailing Address - Phone:617-232-3929
Mailing Address - Fax:617-734-5240
Practice Address - Street 1:2001 BEACON ST STE 102
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-7788
Practice Address - Country:US
Practice Address - Phone:617-232-3929
Practice Address - Fax:617-734-5240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty