Provider Demographics
NPI:1437893872
Name:ATTLEBORO DENTAL GROUP, PLLC
Entity type:Organization
Organization Name:ATTLEBORO DENTAL GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HERR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:508-222-5950
Mailing Address - Street 1:1174 S WASHINGTON ST STE 400
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-4446
Mailing Address - Country:US
Mailing Address - Phone:508-222-5950
Mailing Address - Fax:
Practice Address - Street 1:1174 S WASHINGTON ST STE 400
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-4446
Practice Address - Country:US
Practice Address - Phone:508-222-5950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-22
Last Update Date:2022-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental