Provider Demographics
NPI:1811606056
Name:QUALITAS DENTAL OF MASSACHUSETTS, P.C.,
Entity type:Organization
Organization Name:QUALITAS DENTAL OF MASSACHUSETTS, P.C.,
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF HR
Authorized Official - Prefix:
Authorized Official - First Name:SUZIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGUEIREDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-253-1001
Mailing Address - Street 1:2 COMMERCIAL ST STE 8
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-1661
Mailing Address - Country:US
Mailing Address - Phone:781-253-1001
Mailing Address - Fax:
Practice Address - Street 1:1 FINANCIAL PLZ STE 2100
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-2485
Practice Address - Country:US
Practice Address - Phone:401-263-9518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUALITAS DENTAL PARTNERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-16
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA99Medicaid