Provider Demographics
NPI:1922648070
Name:MANDEL FAMILY DENTAL, PC
Entity Type:Organization
Organization Name:MANDEL FAMILY DENTAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-762-0053
Mailing Address - Street 1:63 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3697
Mailing Address - Country:US
Mailing Address - Phone:781-762-0053
Mailing Address - Fax:781-769-9229
Practice Address - Street 1:63 BROADWAY
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3697
Practice Address - Country:US
Practice Address - Phone:781-762-0053
Practice Address - Fax:781-769-9229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental