Laila Amanda Dantas, D.M.D.

Individual provider Active NPI Pediatric Dentistry · Raynham, MA

NPI 1467748418 · NPPES record last updated Sep 23, 2020

Key facts

NPI
1467748418
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Dentistry 1223P0221X
License
DN1857272 (MA)
Practice address
302 Broadway Unit 1
Raynham, MA 02767-1439
Phone
(508) 884-4000
NPI assigned
Jun 28, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DN1857272MAMDPediatric Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN1857272 MA Yes

Addresses

Primary practice location

302 Broadway Unit 1
Raynham, MA 02767-1439

Mailing address

302 Broadway
Raynham, MA 02767-1439
Phone (508) 884-4000

Other practice location 1

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-2000

Other providers in Raynham, MA

All providers in Raynham, MA · Pediatric Dentistry in Massachusetts

Sources for this page

Verify at the official NPI Registry.