Provider Demographics
NPI:1982351672
Name:DENTAL CLINICAL SOLUTIONS PC
Entity Type:Organization
Organization Name:DENTAL CLINICAL SOLUTIONS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-396-4131
Mailing Address - Street 1:92 HIGH ST STE DH12
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-3839
Mailing Address - Country:US
Mailing Address - Phone:781-396-4131
Mailing Address - Fax:781-396-2064
Practice Address - Street 1:92 HIGH ST STE DH12
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-3839
Practice Address - Country:US
Practice Address - Phone:781-396-4131
Practice Address - Fax:781-396-2064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty