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ADVANCED DENTAL SPA OF FALL RIVER LLC NPI 1356648075


NPI Information

NPI: 1356648075
Provider Name: ADVANCED DENTAL SPA OF FALL RIVER LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 22D2150601

Address:
373 NEW BOSTON RD
FALL RIVER, MA
ZIP 02720
Phone: (508) 567-4544
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ADVANCED DENTAL SPA OF FALL RIVER LLC is a general practice dentist in Fall River, MA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. ADVANCED DENTAL SPA OF FALL RIVER LLC NPI is 1356648075. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

373 NEW BOSTON RD
FALL RIVER, MA
ZIP 02720-814
Phone: (508) 567-4544

The provider's authorized official is Raed Yazbeck .
The authorized official title is Owner and has the following contact phone number (508) 567-4544.

The CLIA number assigned to this NPI record is 22D2150601 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/15/2011 and was last updated on 2/15/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice21657MASSACHUSETTSNo
21223G0001XDentistGeneral Practice22252MASSACHUSETTSYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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