Provider Demographics
NPI:1720416050
Name:MASS ONE DENTAL LLC
Entity Type:Organization
Organization Name:MASS ONE DENTAL LLC
Other - Org Name:ALL PRO DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LI TING
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:978-664-9944
Mailing Address - Street 1:7 EVERETT ST
Mailing Address - Street 2:#D-E
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-5934
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7 EVERETT ST
Practice Address - Street 2:#D-E
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-5934
Practice Address - Country:US
Practice Address - Phone:978-664-9944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18562101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty