Thach, Lee W

Thach, Lee W is an individual health care provider with primary practice located at 186 Elm St , Everett MA 02149-5222. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Thach, Lee W can be contacted via phone (617) 389-2112.

Contact Information

Primary practice address
186 Elm St Everett MA 02149-5222
Phone: (617) 389-2112
Fax: (617) 389-5885
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 19582 Massachusetts

Profile Details

NPI number 1407824741
LBN Legal business name Thach, Lee W
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 11th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407824741 NPPES
Massachusetts MEDICAID 0203220

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