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NPI Code Detail

MEDICARE: PATRICK ASSIOUN DMD PC

MEDICARE: PATRICK ASSIOUN DMD 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
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry20209MA

General Provider Information

NPI Number : 1902075096
Entity Type Code : Organization
Provider Name (Legal Business Name) : PATRICK ASSIOUN DMD PC
Provider Business Mailing Address
First Line : 116 MAIN ST
Second Line :
City : MARLBOROUGH
State : MA
Zip : 01752-3811
Country : US
Telephone Number : 508-485-2001
Fax Number : 508-485-2201
Provider Business Practice Location Address
First Line : 116 MAIN ST
Second Line :
City : MARLBOROUGH
State : MA
Zip : 01752-3811
Country : US
Telephone Number : 508-485-2001
Fax Number : 508-485-2201
Authorized Official
Title or Position : ORTHODONTIST/OWNER
Name : PATRICK ASSIOUN
Credential : DMD, MMSC
Telephone Number : 508-485-2001
Provider Enumeration Date : 02/22/2008
Last Update Date : 02/22/2008

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