NPI 1114247301

Daniel Moheban DMD PC

Organisation Health Maintenance Organization Worcester, MA

Practice location

Address: 200 Lincoln Street, Worcester, MA 01605
Phone: (508) 756-6264
Fax: (508) 756-6490
Mailing address: 200 Lincoln St, Worcester, MA 01605-2528

Authorised official

Name: Daniel B Moheban
Title: Owner
Phone: (508) 756-6264

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 20965 (MA)

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Registry record

NPI: 1114247301
Entity type: Organization
NPI issued: 10 Jun 2010
Record last updated: 10 Jun 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.