Worcester Smiles Youth Dentistry, Llc

LBN: Worcester Smiles Youth Dentistry, Llc
Worcester Smiles Youth Dentistry, Llc is an health care organization with primary practice located at 290 Park Ave , Worcester MA 01609-1805. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Worcester Smiles Youth Dentistry, Llc can be contacted via phone (508) 798-9040, or through Stump, Jenell via phone (615) 750-0343.

Contact Information

Primary practice address
290 Park Ave Worcester MA 01609-1805
Phone: (508) 798-9040
Fax: (508) 798-9060
Website:
Map and Directions
Authorized official contact:
Name: Stump, Jenell
Phone: (615) 750-0343

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X

Profile Details

NPI number 1073661385
LBN Legal business name Worcester Smiles Youth Dentistry, Llc
DBA Doing business as
Authorized official Stump, Jenell
Entity Organization
Organization subpart 1 No
Enumeration date Jan 5th, 2007
Last updated Jul 9th, 2014 - about 10 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 1073661385 NPPES
Massachusetts MEDICAID 110069690A

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