Provider Demographics
NPI:1013925759
Name:MILFORD DENTAL GROUP
Entity Type:Organization
Organization Name:MILFORD DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PEYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEIGI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-482-0028
Mailing Address - Street 1:46 MAIN ST # 48
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-2604
Mailing Address - Country:US
Mailing Address - Phone:508-482-0028
Mailing Address - Fax:508-482-9585
Practice Address - Street 1:46 MAIN ST # 48
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2604
Practice Address - Country:US
Practice Address - Phone:508-482-0028
Practice Address - Fax:508-482-9585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA190491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty