Provider Demographics
NPI:1952066110
Name:A & S DENTAL WELLNESS CENTER OF LOWELL, P. C.
Entity Type:Organization
Organization Name:A & S DENTAL WELLNESS CENTER OF LOWELL, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YIJIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:857-540-1532
Mailing Address - Street 1:21 GEORGE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-2228
Mailing Address - Country:US
Mailing Address - Phone:978-453-8610
Mailing Address - Fax:
Practice Address - Street 1:21 GEORGE ST STE 201
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-2228
Practice Address - Country:US
Practice Address - Phone:978-453-8610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty