Provider Demographics
NPI:1831435395
Name:UNIQUE DENTAL GROUP, PC
Entity type:Organization
Organization Name:UNIQUE DENTAL GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KINAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KANBAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-485-0008
Mailing Address - Street 1:11 COURT ST
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-6903
Mailing Address - Country:US
Mailing Address - Phone:508-485-0008
Mailing Address - Fax:508-485-3919
Practice Address - Street 1:11 COURT ST
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-6903
Practice Address - Country:US
Practice Address - Phone:508-485-0008
Practice Address - Fax:508-485-3919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty