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PROFESSIONAL DENTAL ALLAINCE OF MASSACHUSETTS PLLC
NPI 1245878305
Dentist - General Practice in Boylston, MA

Active since December 19, 2019
17 MAIN ST, BOYLSTON, MA 01505(508) 869-6388 Get Directions Write a Review

NPPES record last updated: December 19, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Professional Dental Allaince Of Massachusetts Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROFESSIONAL DENTAL ALLAINCE OF MASSACHUSETTS PLLC (NPI 1245878305), doing business as Innovative Dental, is a healthcare organization registered as a general practice in Boylston, Massachusetts and active in the NPI registry since December 2019. The organization maintains 2 additional practice locations and lists Andrew Matta, Owner, as its authorized official.

NPPES Registry Identity

NPI1245878305
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePROFESSIONAL DENTAL ALLAINCE OF MASSACHUSETTS PLLC
Location Address17 MAIN STBoylston, MA 01505-1948
Mailing Address11 S Mill St Ste 200New Castle, PA 16101-3680
Phone(508) 869-6388
Organization SubpartNo
Authorized OfficialAndrew MattaOwner · (724) 698-2500
Enumeration DateDecember 19, 2019
✔ NPI 1245878305 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
17 MAIN ST, Boylston, MA 01505
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Other Names 1

Doing Business AsInnovative Dental

Secondary Practice Locations 2

Location 1622 Main StShrewsbury, MA 01545-5639 · Phone (508) 845-1156
Location 2119 S Main StLeicester, MA 01524-1403 · Phone (508) 892-4882

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BOYLSTON DENTAL ASSOCIATES
Dentist (General Practice)
17 MAIN ST
BOYLSTON, MA 01505
Worcester County (508) 869-6388
DR. JONILA BUZZELL DMD
Dentist (General Practice)
17 MAIN ST
BOYLSTON, MA 01505
Worcester County (508) 869-6388
DR. JOHN FRANCIS SCANLON D.M.D.
Dentist (General Practice)
17 MAIN ST
BOYLSTON, MA 01505
Worcester County (508) 869-6388

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Professional Dental Allaince Of Massachusetts PLLC's NPI number?

The NPI number for Professional Dental Allaince Of Massachusetts PLLC is 1245878305. It was assigned to this organization in the NPPES registry on December 19, 2019. The provider is doing business as Innovative Dental.

Where is Professional Dental Allaince Of Massachusetts PLLC located?

Professional Dental Allaince Of Massachusetts PLLC is located at 17 Main St, Boylston, MA 01505. The listed phone number is (508) 869-6388.

What is Professional Dental Allaince Of Massachusetts PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Professional Dental Allaince Of Massachusetts PLLC was last updated on December 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.