Provider Demographics
NPI:1720508161
Name:UNIQUE DENTAL OF WINCHENDON LLC
Entity Type:Organization
Organization Name:UNIQUE DENTAL OF WINCHENDON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:YASER
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:WEHBE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-632-3336
Mailing Address - Street 1:16 SCARLET CT
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-3625
Mailing Address - Country:US
Mailing Address - Phone:508-297-0143
Mailing Address - Fax:
Practice Address - Street 1:77 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:WINCHENDON
Practice Address - State:MA
Practice Address - Zip Code:01475-1609
Practice Address - Country:US
Practice Address - Phone:978-297-0675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-27
Last Update Date:2017-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20518261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental