Provider Demographics
NPI:1730779000
Name:AURA DENTAL CENTER
Entity type:Organization
Organization Name:AURA DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:XIMENA
Authorized Official - Middle Name:D
Authorized Official - Last Name:VENEGAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:862-276-9243
Mailing Address - Street 1:391 LYNNWAY
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1707
Mailing Address - Country:US
Mailing Address - Phone:617-393-5437
Mailing Address - Fax:
Practice Address - Street 1:391 LYNNWAY
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1707
Practice Address - Country:US
Practice Address - Phone:617-393-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty