Mount Ida College Dental Center

LBN: Mount Ida College
Mount Ida College Dental Center is an health care organization with primary practice located at 777 Dedham St , Newton MA 02459-3323. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Mount Ida College can be contacted via phone (617) 928-7360, or through Beckett, Gary Melvin via phone (617) 928-7360.

Contact Information

Primary practice address
777 Dedham St Newton MA 02459-3323
Phone: (617) 928-7360
Fax: (617) 928-7030
Website:
Map and Directions
Authorized official contact:
Name: Beckett, Gary Melvin Doctor of Dental Surgery (DDS)
Phone: (617) 928-7360

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 15111 Massachusetts

Profile Details

NPI number 1902929961
LBN Legal business name Mount Ida College
DBA Doing business as Mount Ida College Dental Center
Authorized official Beckett, Gary Melvin Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 6th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902929961 NPPES
Massachusetts MEDICAID 0297658

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