Provider Demographics
NPI:1972867596
Name:RELIANCE DENTAL CARE INC
Entity Type:Organization
Organization Name:RELIANCE DENTAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GAYATHRI
Authorized Official - Middle Name:
Authorized Official - Last Name:SNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:781-275-2157
Mailing Address - Street 1:363 GREAT RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-2800
Mailing Address - Country:US
Mailing Address - Phone:781-275-2157
Mailing Address - Fax:781-275-2158
Practice Address - Street 1:363 GREAT RD
Practice Address - Street 2:SUITE 205
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-2800
Practice Address - Country:US
Practice Address - Phone:781-275-2157
Practice Address - Fax:781-275-2158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19730122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty