Provider Demographics
NPI:1649422197
Name:ARLINGTON DENTAL GROUP
Entity Type:Organization
Organization Name:ARLINGTON DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FARIBA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESBAH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-643-7788
Mailing Address - Street 1:22 MILL ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-4784
Mailing Address - Country:US
Mailing Address - Phone:781-643-7788
Mailing Address - Fax:781-646-2556
Practice Address - Street 1:22 MILL ST
Practice Address - Street 2:SUITE 202
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4784
Practice Address - Country:US
Practice Address - Phone:781-643-7788
Practice Address - Fax:781-646-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA195811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty