Provider Demographics
NPI:1689711509
Name:NATICK DENTAL PARTNERS LLP
Entity Type:Organization
Organization Name:NATICK DENTAL PARTNERS LLP
Other - Org Name:DRS KANE, TESINE, SOPOROWSKI, & ASSOCIATES DRS KANE, TESINI, SPOROWSKI
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PARTNER/ORTHODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:KANE
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-653-2417
Mailing Address - Street 1:230 POND STREET
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760
Mailing Address - Country:US
Mailing Address - Phone:508-653-2417
Mailing Address - Fax:508-650-5715
Practice Address - Street 1:230 POND STREET
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760
Practice Address - Country:US
Practice Address - Phone:508-653-2417
Practice Address - Fax:508-650-5715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA129191223P0221X
MA126071223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty