Provider Demographics
NPI:1841748506
Name:P S DENTAL MANAGEMENT , INC.
Entity Type:Organization
Organization Name:P S DENTAL MANAGEMENT , INC.
Other - Org Name:UNITED DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMADAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-477-7176
Mailing Address - Street 1:285 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-5719
Mailing Address - Country:US
Mailing Address - Phone:617-207-0705
Mailing Address - Fax:
Practice Address - Street 1:285 MAIN ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-5719
Practice Address - Country:US
Practice Address - Phone:617-207-0705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty