Provider Demographics
NPI:1659812899
Name:BELMONT PERIODONTICS AND DENTAL IMPLANTS
Entity Type:Organization
Organization Name:BELMONT PERIODONTICS AND DENTAL IMPLANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TARANEH
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGHIEH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-484-0475
Mailing Address - Street 1:18 MOORE ST
Mailing Address - Street 2:300
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2525
Mailing Address - Country:US
Mailing Address - Phone:617-484-0475
Mailing Address - Fax:617-484-3233
Practice Address - Street 1:18 MOORE ST
Practice Address - Street 2:300
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-2525
Practice Address - Country:US
Practice Address - Phone:617-484-0475
Practice Address - Fax:617-484-3233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA181861223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty