Provider Demographics
NPI:1164457487
Name:GOOD IMPRESSIONS INC
Entity type:Organization
Organization Name:GOOD IMPRESSIONS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MEERA
Authorized Official - Middle Name:
Authorized Official - Last Name:OHRI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-872-5555
Mailing Address - Street 1:463 WORCESTER RD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-5356
Mailing Address - Country:US
Mailing Address - Phone:508-872-5555
Mailing Address - Fax:508-620-7939
Practice Address - Street 1:463 WORCESTER RD
Practice Address - Street 2:SUITE 404
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-5356
Practice Address - Country:US
Practice Address - Phone:508-872-5555
Practice Address - Fax:508-620-7939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20255122300000X
MA183611223E0200X
MA168131223P0300X
MA88681223X0400X
MA14852122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty