Provider Demographics
NPI:1902153752
Name:ONE DENTAL CARE, PC
Entity Type:Organization
Organization Name:ONE DENTAL CARE, PC
Other - Org Name:ONE DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KUNIO
Authorized Official - Middle Name:KWOK-HUNG
Authorized Official - Last Name:KUNIO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-458-2259
Mailing Address - Street 1:111 DOW AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-7139
Mailing Address - Country:US
Mailing Address - Phone:617-458-2259
Mailing Address - Fax:
Practice Address - Street 1:1682 BEACON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-2120
Practice Address - Country:US
Practice Address - Phone:617-458-2259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-11
Last Update Date:2012-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN212621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty