Lowell Family Dental Practice Pc
General Practice Dentistry in Lowell, MA(View on Map)
Legal Business Name
Lowell Family Dental Practice Pc
NPI Number
1588790067
NPI Type
Organization
Enumeration Date
02/26/2007
Specialties
(Taxonomies)Licenses
State
Massachusetts
Massachusetts
Massachusetts
License Number
18197
21536
21444
Contact
Information
Purpose
Mailing
Location
Address
133 MARKET STREET
133 MARKET STREET
City
Lowell
Lowell
State
MA
MA
Postal Code
01852-1808
01852-1808
Country
US
US
Telephone Number
(978) 458-1179
(978) 458-1179
Authorized Official
Name
Dr. Konstantin Amirzadov
Title or Position
PRESIDENT
Telephone Number
(978) 458-1179
Identifiers
Identifier
9727230
X11619
Identifier State
MA
MA
Identifier Issuer
Unknown
BLUE CROSS BLUE SHIELD
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 08/22/2020
Provider Address
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