Provider Demographics
NPI:1831513720
Name:HAPPY KIDS DENTAL
Entity type:Organization
Organization Name:HAPPY KIDS DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SATHISH
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOBICHETTYPALAYAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:617-980-4734
Mailing Address - Street 1:223 WALNUT STREET
Mailing Address - Street 2:SUITE #22
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702
Mailing Address - Country:US
Mailing Address - Phone:508-620-5437
Mailing Address - Fax:508-820-3031
Practice Address - Street 1:223 WALNUT STREET
Practice Address - Street 2:SUITE #22
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702
Practice Address - Country:US
Practice Address - Phone:508-620-5437
Practice Address - Fax:508-820-3031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA22099261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental