Provider Demographics
NPI:1134987654
Name:WHITE ARCH DENTAL PLLC
Entity type:Organization
Organization Name:WHITE ARCH DENTAL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:UMMESALMA
Authorized Official - Middle Name:IQBAL
Authorized Official - Last Name:DHARIWALA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-318-0528
Mailing Address - Street 1:25 DUNIA LN
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-2460
Mailing Address - Country:US
Mailing Address - Phone:732-318-0528
Mailing Address - Fax:
Practice Address - Street 1:325 AYER RD STE B110A
Practice Address - Street 2:
Practice Address - City:HARVARD
Practice Address - State:MA
Practice Address - Zip Code:01451-1179
Practice Address - Country:US
Practice Address - Phone:978-772-6658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-08
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty