Provider Demographics
NPI:1922313477
Name:EDGAR E MENDOZA AND PATRICIA A SLININ DMD PC
Entity Type:Organization
Organization Name:EDGAR E MENDOZA AND PATRICIA A SLININ DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:E
Authorized Official - Last Name:MENDZA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-755-1293
Mailing Address - Street 1:70 ELM ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-2300
Mailing Address - Country:US
Mailing Address - Phone:508-755-1293
Mailing Address - Fax:508-798-5256
Practice Address - Street 1:70 ELM ST
Practice Address - Street 2:SUITE 1
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-2300
Practice Address - Country:US
Practice Address - Phone:508-755-1293
Practice Address - Fax:508-798-5256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty