Provider Demographics
NPI:1700364866
Name:PEOPLESDENTAL, P.C.
Entity Type:Organization
Organization Name:PEOPLESDENTAL, P.C.
Other - Org Name:NEWTON CENTRE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MAYLOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-874-8198
Mailing Address - Street 1:1400 CENTRE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2414
Mailing Address - Country:US
Mailing Address - Phone:860-874-8198
Mailing Address - Fax:
Practice Address - Street 1:1400 CENTRE ST STE 201
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-2414
Practice Address - Country:US
Practice Address - Phone:617-965-2440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEOPLESDENTAL, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-01
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty