Provider Demographics
NPI:1528238177
Name:STEVEN D GARLAND DMD PC
Entity type:Organization
Organization Name:STEVEN D GARLAND DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:GARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-331-2422
Mailing Address - Street 1:851 MAIN STREET
Mailing Address - Street 2:SUITE 20
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190
Mailing Address - Country:US
Mailing Address - Phone:781-331-2422
Mailing Address - Fax:781-331-2780
Practice Address - Street 1:851 MAIN STREET
Practice Address - Street 2:SUITE 20
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190
Practice Address - Country:US
Practice Address - Phone:781-331-2422
Practice Address - Fax:781-331-2780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA118661223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0247588Medicaid
MA0247588Medicaid