42 North Dental Care, LLC
Organization Active NPI Dental Clinic/Center · South Boston, MA
NPI 1346519006 · NPPES record last updated Jun 21, 2021
Key facts
- NPI
- 1346519006
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- Legal business name
- 42 NORTH DENTAL CARE, LLC
- Practice address
- 368A W Broadway # a
South Boston, MA 02127-2215 - Phone
- (617) 269-0004
- NPI assigned
- Dec 23, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- 42 NORTH DENTAL CARE, LLC
Authorized official
- Name
- Dr. Michael Angelo Scialabba, DDS
- Title
- Chief Clinical Officer
- Phone
- (561) 512-2709
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- 42 North Dental Care LLC
- Part of
- 42 North Dental Care LLC
Locations
368A W Broadway
#A
South Boston, MA 02127
Phone (617) 269-0004
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Yes |
Addresses
Primary practice location
368A W Broadway # a
South Boston, MA 02127-2215
Mailing address
200 5TH Ave FL 3
Waltham, MA 02451-8759
Phone (781) 647-0772
Other names
- Gentle Dental South Boston
Other providers in South Boston, MA
- 804 East 7TH Street Operator LLC
- A Spot of Therapy
- Abdirizak Aden
- Advanced OT of Boston
- Nicole Alessio
All providers in South Boston, MA · Dental Clinic/Center in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.