Provider Demographics
NPI:1295251007
Name:IONA DENTAL, P.C. (PARENT ORGANIZATION)
Entity type:Organization
Organization Name:IONA DENTAL, P.C. (PARENT ORGANIZATION)
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HANS
Authorized Official - Middle Name:A
Authorized Official - Last Name:LANGARA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MSD
Authorized Official - Phone:617-858-0211
Mailing Address - Street 1:10 GRANITE STREET
Mailing Address - Street 2:UNIT - 4C
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169
Mailing Address - Country:US
Mailing Address - Phone:617-858-0211
Mailing Address - Fax:
Practice Address - Street 1:10 GRANITE STREET
Practice Address - Street 2:UNIT - 4C
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169
Practice Address - Country:US
Practice Address - Phone:617-858-0211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IONA DENTAL, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN201111223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty