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Alliance Dental Center, LLC

Organization Active NPI General Practice Dentistry · Quincy, MA

NPI 1922566041 · NPPES record last updated Jan 5, 2021

Key facts

NPI
1922566041
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
ALLIANCE DENTAL CENTER, LLC
Practice address
111 Washington St Ste 301
Quincy, MA 02169-5354
Phone
(617) 984-5300
Fax
(617) 481-0905
NPI assigned
Mar 7, 2019
Organization subpart
No

Authorized official

Name
Susan Fournier
Title
Ceo
Phone
(617) 426-5878

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2228621Alliance Dental Center, LLC
111 Washington Street, Quincy, MA 02169		Certificate of waiverJun 28, 2027

National Provider Directory

Locations

111 Washington St
Ste 301
Quincy, MA 02169
Phone (617) 984-5300

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP		 1223G0001X Yes

Addresses

Primary practice location

111 Washington St Ste 301
Quincy, MA 02169-5354

Mailing address

PO Box 4114
Peabody, MA 01961-4114
Phone (617) 426-5878

Other providers in Quincy, MA

All providers in Quincy, MA · General Practice Dentistry in Massachusetts

Sources for this page

Verify at the official NPI Registry.