Provider Demographics
NPI:1144526807
Name:DENTAL HEALTH SOLUTIONS OF NORTH ANDOVER, LLC
Entity type:Organization
Organization Name:DENTAL HEALTH SOLUTIONS OF NORTH ANDOVER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AKHTAR
Authorized Official - Middle Name:G
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-686-3511
Mailing Address - Street 1:33 WALKER RD STE 2
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-1900
Mailing Address - Country:US
Mailing Address - Phone:978-686-3511
Mailing Address - Fax:
Practice Address - Street 1:33 WALKER RD STE 2
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-1900
Practice Address - Country:US
Practice Address - Phone:978-686-3511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-28
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18352122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty