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NPI Code Detail

MEDICARE: SUDBURY ENDODONTICS, PC

MEDICARE: SUDBURY ENDODONTICS, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223E0200XEndodontics20095MA

General Provider Information

NPI Number : 1891874632
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUDBURY ENDODONTICS, PC
Provider Business Mailing Address
First Line : 111 BOSTON POST RD
Second Line : SUITE 215
City : SUDBURY
State : MA
Zip : 01776-2463
Country : US
Telephone Number : 978-443-7101
Fax Number :
Provider Business Practice Location Address
First Line : 111 BOSTON POST RD
Second Line : SUITE 215
City : SUDBURY
State : MA
Zip : 01776-2463
Country : US
Telephone Number : 978-443-7101
Fax Number :
Authorized Official
Title or Position : OPERATIONS
Name : MICHAEL L ZEPF
Credential :
Telephone Number : 508-740-9928
Provider Enumeration Date : 11/03/2006
Last Update Date : 02/21/2008

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Directions to “SUDBURY ENDODONTICS, PC ” Practice Location

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