Provider Demographics
NPI:1518406453
Name:DDMDMD DENTAL ASSOC
Entity type:Organization
Organization Name:DDMDMD DENTAL ASSOC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-893-7500
Mailing Address - Street 1:32 WEXFORD STREET
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-2912
Mailing Address - Country:US
Mailing Address - Phone:781-449-0477
Mailing Address - Fax:781-400-5130
Practice Address - Street 1:32 WEXFORD STREET
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-2912
Practice Address - Country:US
Practice Address - Phone:781-449-0477
Practice Address - Fax:781-400-5130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty