Provider Demographics
NPI:1255411799
Name:LOWELL DENTISTRY FOR CHILDREN
Entity type:Organization
Organization Name:LOWELL DENTISTRY FOR CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:WATMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:978-323-4399
Mailing Address - Street 1:75 ARCAND DR
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1026
Mailing Address - Country:US
Mailing Address - Phone:978-323-4399
Mailing Address - Fax:
Practice Address - Street 1:75 ARCAND DR
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1026
Practice Address - Country:US
Practice Address - Phone:978-323-4399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA170941223P0221X
MA109661223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty