Provider Demographics
NPI:1518049196
Name:THE CENTER FOR PEDIATRIC DENTAL CARE
Entity type:Organization
Organization Name:THE CENTER FOR PEDIATRIC DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:617-731-5437
Mailing Address - Street 1:1560 BEACON ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-2206
Mailing Address - Country:US
Mailing Address - Phone:617-731-5437
Mailing Address - Fax:617-734-4780
Practice Address - Street 1:1560 BEACON ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-2206
Practice Address - Country:US
Practice Address - Phone:617-731-5437
Practice Address - Fax:617-734-4780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty