MASS KIDZ HEALTHY SMILES LLC
Managed Care Organizations at Audubon Ave, Braintree, MA

License number
Massachusetts DH11340
Category
Managed Care Organizations
Type
Exclusive Provider Organization
Owner
Name: MRS. KATHLEEN M LUISI R.D.H.
Title: MANAGER
Phone: (617) 913-3321
Address
Address
126 Audubon Ave, Braintree, MA 02184
National Provider ID: 1952658056
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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MASS KIDZ HEALTHY SMILES LLC

126 Audubon Ave, Braintree, MA 02184

Registration:
Aug 6, 2012
State ID:
001085161
Business type:
Domestic Limited Liability Company (LLC)
Manager:
Kathleen M Luisi Rdh (Manager), 126 Audubon Ave, Braintree, MA 02184 (Physical)
Agent:
Rdh Kathleen M. Luisi,126 Audubon Ave, Braintree, MA 02184 (Physical)

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