Provider Demographics
NPI:1881614238
Name:THE DENTAL PLACE
Entity type:Organization
Organization Name:THE DENTAL PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:P
Authorized Official - Last Name:LAPRIORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-366-0122
Mailing Address - Street 1:24 LYMAN ST
Mailing Address - Street 2:SUITE 240
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1482
Mailing Address - Country:US
Mailing Address - Phone:508-366-0122
Mailing Address - Fax:508-366-2522
Practice Address - Street 1:24 LYMAN ST
Practice Address - Street 2:SUITE 240
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1482
Practice Address - Country:US
Practice Address - Phone:508-366-0122
Practice Address - Fax:508-366-2522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208711223G0001X
MA188401223P0221X
MA207821223P0221X
MA199451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty