Provider Demographics
NPI:1821864901
Name:DENTAL TEAM OF WORCESTER LLC
Entity Type:Organization
Organization Name:DENTAL TEAM OF WORCESTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:AIGUIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-308-5361
Mailing Address - Street 1:580 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-1916
Mailing Address - Country:US
Mailing Address - Phone:508-852-4646
Mailing Address - Fax:508-853-7840
Practice Address - Street 1:580 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-1916
Practice Address - Country:US
Practice Address - Phone:508-852-4646
Practice Address - Fax:508-853-7840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty