Provider Demographics
NPI:1487069522
Name:NELSON J. HUANG FAMILY DENTAL LLC
Entity type:Organization
Organization Name:NELSON J. HUANG FAMILY DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:J
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-879-1270
Mailing Address - Street 1:61 LINCOLN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-8264
Mailing Address - Country:US
Mailing Address - Phone:508-879-1270
Mailing Address - Fax:
Practice Address - Street 1:61 LINCOLN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8264
Practice Address - Country:US
Practice Address - Phone:508-879-1270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-27
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA197181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty