Provider Demographics
NPI:1902356306
Name:MD CONSULTANTS, INC
Entity Type:Organization
Organization Name:MD CONSULTANTS, INC
Other - Org Name:KANGAROO SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:BEYLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MMSC, MDT
Authorized Official - Phone:978-425-1496
Mailing Address - Street 1:413 BROADWAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-2062
Mailing Address - Country:US
Mailing Address - Phone:978-425-1496
Mailing Address - Fax:978-215-5265
Practice Address - Street 1:413 BROADWAY
Practice Address - Street 2:SUITE B
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-2062
Practice Address - Country:US
Practice Address - Phone:978-425-1496
Practice Address - Fax:978-215-5265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856357261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental